@article{3118452,
    title = "Central-line-associated bloodstream infections, multi-drug-resistant bacteraemias and infection control interventions: a 6-year time-series analysis in a tertiary care hospital in Greece",
    author = "Papanikolopoulou, A. and Maltezou, H.C. and Gargalianos-Kakolyris, P. and Michou, I. and Kalofissoudis, Y. and Moussas, N. and Pantazis, N. and Kotteas, E. and Syrigos, K.N. and Pantos, C. and Tountas, Y. and Tsakris, A. and Kantzanou, M.",
    journal = "JOURNAL OF HOSPITAL INFECTION",
    year = "2022",
    volume = "123",
    pages = "27-33",
    publisher = "W.B. Saunders Ltd",
    issn = "0195-6701",
    doi = "10.1016/j.jhin.2022.01.020",
    abstract = "Background: Central-line-associated bloodstream infections (CLABSIs) are serious healthcare-associated infections with substantial morbidity and hospital costs. Aim: To investigate the association between the incidence of CLABSIs, the implementation of specific infection control measures, and the incidence of multi-drug-resistant (MDR) bacteraemias in a tertiary care hospital in Greece from 2013 to 2018. Methods: Analysis was applied for the following indices, calculated monthly: CLABSI rate; use of hand hygiene disinfectants; isolation rate of patients with MDR bacteria; and incidence of bacteraemias [total Gram-negative carbapenem-resistant Acinetobacter baumanii, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae; and/or Gram-positive meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci]. Findings: The total number of bacteraemias from carbapenem-resistant Gram-negative pathogens was significantly correlated with an increased CLABSI rate for all (total) hospital departments [incidence rate ratio (IRR) 1.17, 95% confidence interval (CI) 1.05–1.31, P=0.006] and the adult intensive care unit (ICU) (IRR 1.37, 95% CI 1.07–1.75, P=0.013). In the adult ICU, every increase in the incidence of each resistant Gram-negative pathogen was significantly correlated with a decreased CLABSI rate (carbapenem-resistant A. baumanii: IRR 0.59, 95% CI 0.39–0.90, P=0.015; carbapenem-resistant K. pneumoniae: IRR 0.48, 95% CI 0.25–0.94, P=0.031; carbapenem-resistant P. aeruginosa: IRR 0.54, 95% CI 0.33–0.89, P=0.015). The use of hand disinfectants was correlated with a decreased CLABSI rate 1–3 months before the application of this intervention for all (total) hospital departments (IRR 0.80, 95% CI 0.69–0.93, P=0.005), and for scrub disinfectants in the current month for the adult ICU (IRR 0.34, 95% CI 0.11–1.03, P=0.057). Isolation of patients with MDR pathogens was not associated with the incidence of CLABSIs. Conclusion: Hand hygiene was associated with a significant reduction in the incidence of CLABSIs at the study hospital. Time-series analysis is an important tool to evaluate infection control interventions. © 2022 The Healthcare Infection Society"
}