Central Line-associated Bloodstream Infection (CLABSI) Basics

Central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system – but they are preventable.

A central line (also known as a central venous catheter) is a catheter (tube) that healthcare providers often place in a large vein in the neck, chest or groin to give medication or fluids or to collect blood for medical tests. Central lines are different from peripheral IVs (shorter IVs placed in the hand, arm or foot for vein access); central lines access a major vein close to the heart, can remain in place for weeks or months, and are much more likely to be a source of serious infection. Central lines are commonly used in intensive care units.

Healthcare providers may insert central lines to:

• Give medicines for treatment of pain, infection or other medical issues (e.g., cancer or heart problems).
• Provide fluids or nutrition.
• Help conduct certain medical tests.

Types

Types of central lines

• Peripherally inserted central catheter (PICC). Placed into a vein in the arm.
• Tunneled catheter. Passed under the skin and placed into a vein in the chest or neck. Providers can insert medicine right into the catheter.
• Implanted port. Surgically placed under the skin. Providers insert medicines using a needle placed through the skin into the catheter. An implanted port is not as visible as a tunneled catheter, does not require as much daily care, and does not get in the way of a patient's regular activities as much as a PICC line or a tunneled catheter might.

Healthcare providers use the type that is best for each patient's care.

Signs and symptoms

People with CLABSIs may experience:

• Fever
• Red skin and soreness around the central line

Causes

CLABSIs occur when germs (usually bacteria or fungi) enter the bloodstream through the central line.

Prevention

Healthcare providers should follow recommended infection control guidelines to reduce the risk of CLABSIs.

• Speak up . Talk to your healthcare providers about any questions or worries. Ask what they're doing to protect you.
• Ask a healthcare provider about your options and the pros and cons of a central line, if one is needed. If so, ask them to help you understand the need for it and how long it will be in place.
• Avoid touching the tubing and where it exits the skin as much as possible.

What CDC is doing

• Tracking CLABSIs through the National Healthcare Safety Network.
  • Data is also available on the AR & Patient Safety Portal

  Resources and tools

  • Strategies to prevent CLABSIs in acute-care hospitals: 2022 Update
  • Checklist for Prevention of CLABSI
  • O'Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. 2011
  • Kallen A, Patel P. Healthcare associated infections (HAI): central line-associated bloodstream infections (CLABSIs) in non-intensive care unit (non-ICU) settings toolkit activity C: ELC Prevention Collaboratives