Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome
Introduction: Patients on central lines are often having multiple morbidities, and invasive devices provide a niche for biofilm formation, which makes central line-associated bloodstream infections (CLABSIs), a serious concern in health-care settings, as the infections difficult to treat. In this s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Global Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.jgid.org/article.asp?issn=0974-777X;year=2023;volume=15;issue=2;spage=59;epage=65;aulast=Arunan |
| _version_ | 1797773813611495424 |
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| author | Bharathi Arunan Nishat H Ahmed Arti Kapil Naval K Vikram Sanjeev Sinha Ashutosh Biswas Gita Satpathy Naveet Wig |
| author_facet | Bharathi Arunan Nishat H Ahmed Arti Kapil Naval K Vikram Sanjeev Sinha Ashutosh Biswas Gita Satpathy Naveet Wig |
| author_sort | Bharathi Arunan |
| collection | DOAJ |
| description | Introduction: Patients on central lines are often having multiple morbidities, and invasive devices provide a niche for biofilm formation, which makes central line-associated bloodstream infections (CLABSIs), a serious concern in health-care settings, as the infections difficult to treat. In this study, we evaluated the common bacteria causing CLABSI, and various patient and pathogen factors affecting the clinical outcome. Methods: In the prospective observational study, patients diagnosed with CLABSI were recruited. Extensive clinical, microbiological, and other laboratory workup was done, and observations were recorded. Congo red agar method, tube test, and microtiter plate assay were used for eliciting the biofilm-forming attributes of the bacterial pathogens. Results: Klebsiella pneumoniae was responsible for 48% of CLABSI, followed by Coagulase-negative Staphylococci (16%) and Staphylococcus aureus and Acinetobacter baumannii (12% each). Fifty-six percent of the isolates produced biofilms. The median (interquartile range) duration of hospital stay till death or discharge was 30 (20, 43) days. The all-cause mortality was 44%. Patients having a deranged liver function on the day of diagnosis (P value for total bilirubin 0.001 and for aspartate transaminase 0.02), and those infected with multidrug-resistant organisms (P value = 0.04) had significantly poor prognosis. The difference in the demographic, clinical, laboratory profile, and outcome of patients infected with biofilm producers and nonproducers was not found to be statistically significant. Conclusion: The study throws light on various host and pathogen factors determining the cause and outcome of CLABSI patients. To the best of our knowledge, this is the first study trying to decipher the role of biofilm formation in the virulence of pathogens and the prognosis of CLABSI. |
| first_indexed | 2024-03-12T22:11:47Z |
| format | Article |
| id | doaj.art-621db67f94604a09b653e88085c152fc |
| institution | Directory Open Access Journal |
| issn | 0974-777X |
| language | English |
| last_indexed | 2024-03-12T22:11:47Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Global Infectious Diseases |
| spelling | doaj.art-621db67f94604a09b653e88085c152fc2023-07-23T11:32:46ZengWolters Kluwer Medknow PublicationsJournal of Global Infectious Diseases0974-777X2023-01-01152596510.4103/jgid.jgid_213_22Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcomeBharathi ArunanNishat H AhmedArti KapilNaval K VikramSanjeev SinhaAshutosh BiswasGita SatpathyNaveet WigIntroduction: Patients on central lines are often having multiple morbidities, and invasive devices provide a niche for biofilm formation, which makes central line-associated bloodstream infections (CLABSIs), a serious concern in health-care settings, as the infections difficult to treat. In this study, we evaluated the common bacteria causing CLABSI, and various patient and pathogen factors affecting the clinical outcome. Methods: In the prospective observational study, patients diagnosed with CLABSI were recruited. Extensive clinical, microbiological, and other laboratory workup was done, and observations were recorded. Congo red agar method, tube test, and microtiter plate assay were used for eliciting the biofilm-forming attributes of the bacterial pathogens. Results: Klebsiella pneumoniae was responsible for 48% of CLABSI, followed by Coagulase-negative Staphylococci (16%) and Staphylococcus aureus and Acinetobacter baumannii (12% each). Fifty-six percent of the isolates produced biofilms. The median (interquartile range) duration of hospital stay till death or discharge was 30 (20, 43) days. The all-cause mortality was 44%. Patients having a deranged liver function on the day of diagnosis (P value for total bilirubin 0.001 and for aspartate transaminase 0.02), and those infected with multidrug-resistant organisms (P value = 0.04) had significantly poor prognosis. The difference in the demographic, clinical, laboratory profile, and outcome of patients infected with biofilm producers and nonproducers was not found to be statistically significant. Conclusion: The study throws light on various host and pathogen factors determining the cause and outcome of CLABSI patients. To the best of our knowledge, this is the first study trying to decipher the role of biofilm formation in the virulence of pathogens and the prognosis of CLABSI.http://www.jgid.org/article.asp?issn=0974-777X;year=2023;volume=15;issue=2;spage=59;epage=65;aulast=Arunanantimicrobial resistancebiofilm formationcentral line-associated bloodstream infectionscentral line |
| spellingShingle | Bharathi Arunan Nishat H Ahmed Arti Kapil Naval K Vikram Sanjeev Sinha Ashutosh Biswas Gita Satpathy Naveet Wig Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome Journal of Global Infectious Diseases antimicrobial resistance biofilm formation central line-associated bloodstream infections central line |
| title | Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome |
| title_full | Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome |
| title_fullStr | Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome |
| title_full_unstemmed | Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome |
| title_short | Central line-associated bloodstream infections: Effect of patient and pathogen factors on outcome |
| title_sort | central line associated bloodstream infections effect of patient and pathogen factors on outcome |
| topic | antimicrobial resistance biofilm formation central line-associated bloodstream infections central line |
| url | http://www.jgid.org/article.asp?issn=0974-777X;year=2023;volume=15;issue=2;spage=59;epage=65;aulast=Arunan |
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