Risk Factor Prediction Model for Catheter-Associated Bloodstream Infections (CABSIs) in Midline and Central Venous...

Area of Science:

• Infectious Diseases
• Medical Device Infections
• Epidemiology

Background:

• Venous catheter placement is a common hospital procedure with risks of catheter-associated bloodstream infections (CABSIs).
• Previous studies on risk factors for CABSIs have yielded inconsistent results.
• Identifying reliable risk factors is crucial for effective infection control.

Purpose of the Study:

• To identify independent risk factors for CABSIs in patients with various types of venous catheters.
• To develop and validate a predictive model for CABSIs.
• To improve clinical decision-making and infection prevention strategies.

Main Methods:

• Observational cohort follow-up study (January 2016 - March 2022).
• Patients with midline, CICC, or PICC catheters were assigned to derivation (n=6036) and validation (n=1549) cohorts.
• Multivariable logistic regression and backward stepwise regression were used to identify predictors and build the model.

Main Results:

• CABSIs prevalence was 1.8% in the derivation cohort.
• Independent risk factors identified: tracheostomy, recent bacteremia, synchronous central catheter, active oncohematological disease, and total parenteral nutrition (TPN).
• The predictive model showed good performance (AUC 0.73 derivation, 0.77 validation) and clinical utility.

Conclusions:

• A validated model can identify patients at high risk for CABSIs.
• The model supports risk-based clinical decisions, potentially reducing catheter use and improving antimicrobial stewardship.
• This tool aids in infection prevention efforts in hospitalized patients with venous catheters.