Daniel Vazquez, MD
Medical Director, Surgical Intensive Care Unit
n/a, United States
Disclosure information not submitted.
Jessica Krizo, PhD
Research Faculty
Cleveland Clinic Akron General
Akron, Ohio, United States
Disclosure information not submitted.
Ali Mallat, MD, MS, FACS
Executive Medical Director, Acute Care Surgery
Cleveland Clinic Akron General, United States
Disclosure information not submitted.
Kaitlin Vazquez, DNP, CRNA
CRNA
Cleveland Clinic Akron General, United States
Disclosure information not submitted.
Title: Covid-19 and Central Line Associated Bloodstream Infection: A Single Tertiary Center Experience
INTRODUCTION/HYPOTHESIS: An increase in the rates of central line-associated bloodstream infections (CLABSI) during the COVID-19 pandemic has been previously described. While the factors driving this increase are not entirely clear, COVID-19 associated CLABSI have demonstrated unique patterns of occurrence and etiology. The purpose of this investigation was to examine the data from institutional CLABSI infections and identify risk factors for CLABSI development in the presence of COVID-19.
Methods: A retrospective, case series review of all CLABSI events occurring at our institution since the emergence of COVID-19 in the United States in early 2020 was performed. Data abstracted includes demographic details, line and CLABSI characteristics and details regarding hospital stay. Descriptive statistics were used to explore the relationship between COVID-19 positive (COVID+) CLABSI infections and COVID-19 negative (COVID-) CLABSI infections. Where applicable, Fisher’s Exact Test and Mann-Whitney U Test were used to compare proportions and averages between groups respectively.
Results: During this time, 18 total CLABSI were identified, including 8 with a diagnosis of active COVID-19. Patients had a mean age of 62 (± 15) years old, were predominately white (61%), male (66%), and on Medicare (55%). Males made up a greater proportion of COVID+ CLABSI patients (87.5%). Primary diagnoses varied widely with secondary diagnoses including bacteremia (66%) and fungemia (22%). There was no difference in number of central line, ventilator, intensive care unit, or hospital days between groups. Antibiotic use at time of line placement and type of central line were consistent between groups. Steroid use at time of line placement was more common in COVID+ patients (88%, p=.01).
Conclusion: The power of this study restricts analysis, however, having received doses of steroids as well as being male illustrated higher rates of COVID+ CLABSI at our institution. These findings suggest that susceptibility to CLABSI in COVID+ patients results from an underlying etiology rather than procedural limitations in COVID+ care, and therefore warrant further investigation to determine potential risk factors for developing COVID+ CLABSI.