CDC and NIH new guidelines: BSIs largely preventable

January 12th, 2015

Public health officials and clinicians continue an unrelenting focus on a deadly infection that appears to be almost completely preventable: catheter-related bloodstream infections (CRBSI).

The latest initiative comes in the form of new and updated guidelines by the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC). The guidelines were developed by a working group led by clinical scientists from the National Institutes of Health Clinical Center Critical Care Medicine Department (CCMD) along with 14 other professional organizations. They new guidelines are available at the HICPAC website. Major areas of emphasis in the guidelines include educating and training health care personnel, using maximal sterile barrier precautions during catheter insertion, cleaning skin with chlorhexidine (an antibacterial scrub), and avoiding routine replacement of certain catheters.

Replacing a 2002 edition – a lot has changed in 9 years in BSI prevention - the new guidelines are titled "Guidelines for the Prevention of Intravascular Catheter-Related Infections" and were published April 1, 2011, in Clinical Infectious Diseases. They will also be included in a special supplement to the American Journal of Infection Control.

Catheter-related bloodstream infections—like many infections in health care—are now seen as largely preventable," says lead author Naomi O'Grady, MD, medical director of procedures, vascular access, and conscious sedation services at the NIH Clinical Center CCMD. "Implementation of these critical infection control guidelines is an important benchmark of health care quality and patient safety."

Efforts to track, report, and prevent bloodstream infections have improved in recent years. As part of its Action Plan to Prevent HAIs, the U.S. Department of Health and Human Services has a national goal of reducing one type of CRBSI, central line-associated bloodstream infections (CLABSI), by 50% by 2013.

Starting in 2011, hospitals throughout the country must track and report CLABSIs in intensive care units in order to get an annual 2% Medicare payment increase. Hospitals will report their infection rates to CDC's National Healthcare Safety Network, and the data will be shared with the Centers for Medicare and Medicaid Services. These data will be made available to the public later this year on the Hospital Compare website.