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Epidemiological Trends and Multidrug-Resistant Patterns in Central Line-Associated Bloodstream Infections Among Bone
Sawsan Mubarak1, Joud Jarrah2, Hadeel AlGhawrie1
1Infection Control Program, King Hussein Cancer Center, Amman, Jordan.
Background And Objective:
Central Line-Associated Bloodstream Infections (CLABSIs) considered a significant challenge in healthcare settings, necessitating vigilant monitoring and intervention strategies especially among patients undergoing Hematopoietic Stem Cell Transplantation (HSCT). This study aims to conduct comprehensive analysis of CLABSI cases among HSCT patients; trends in incidence, device associations, causative organisms, and multidrug-resistant patterns.
Methodology:
A retrospective analysis was conducted on HSCT patients who developed CLABSI at the King Hussein Cancer Center between January 2019 and December 2023. Data collected included demographic data (age and sex), Diagnosis, type of vascular access device (VAD), Organism, bacterial resistance pattern, and last follow-up status and date were collected for patients. Overall survival analysis was performed using the Kaplan-Meier method, with results reported at 30, 60, and 100 days post-infection.
Results:
Over the 5-year period, 169 HSCT patients had CLABSI were included, the majority were male (65.7%), with 73% adults and 27% pediatric patients, and a mean age of 33.6 years. The most common diagnoses were lymphoma (25.4%) and leukemias (24.9%). Gram-negative bacteria were the predominant cause of infection, accounting for 85% of cases, followed by Gram-positive bacteria (13.0%) and fungi (2.4%). Escherichia coli was the most frequent causative organism (46%), followed by Klebsiella pneumoniae (8%) and Pseudomonas aeruginosa (5%). Multidrug-resistant pathogens, particularly Extended-Spectrum Beta-Lactamase (ESBL) producing strains and Carbapenem-resistant Enterobacteriaceae (CRE), were prevalent. Hickman devices were associated with the highest number of CLABSI cases (63.9%). The overall survival rates were 83.4% at 30 days, 80.5% at 60 days, and 78.1% at 100 days post-CLABSI.
Conclusion:
This study provides a comprehensive overview of CLABSI epidemiology among HSCT patients in Jordan, highlighting the high prevalence of Gram-negative and multidrug-resistant organisms. These findings underscore the critical need for continuous surveillance, targeted infection control measures, and effective antimicrobial stewardship to improve patient safety and outcomes in this high-risk population.
