الملخص الإنجليزي
Background: Central line-associated bloodstream infections (CLABSIs) are among the
three most common types of hospital-acquired infection, especially in critical care
settings. They have a significant impact on both patients and the healthcare system. Much
research into CLABSIs has been conducted worldwide, documenting their huge negative
impact on the mortality rate, length of hospital stays, and healthcare costs. Despite the
extensive use of central lines for ICU patients in Oman, no studies have been conducted
among adult ICU patients to assess the prevalence, predictors, and outcomes of CLABSIs.
Aim: This study aims to measure the prevalence of ICU-acquired CLABSIs, identify the
most common causative microorganisms, define possible related risk factors, and
estimate the mortality rate, length of hospital stays, and extra healthcare costs associated
with ICU-acquired CLABSIs among adult ICU patients in Oman.
Method: A retrospective case-control design was used to meet the study objectives. A
complete electronic medical records review was conducted for all adult ICU patient'
admissions over two years (2018-2019) in two tertiary hospitals in Oman to allocate a
case group (n = 58) and a randomly selected control group (n = 174).
Results: The prevalence of ICU-acquired CLABSIs was 8.9 and 8.31 per 1000 catheter
days for the years 2018 and 2019 respectively. The most common isolated
microorganisms were gram-positive bacteria (46.6%). The risk factors for ICU-acquired
CLABSIs are: heart failure (Odds Ratio [OR] = 11.67, p < 0.001), presence of other
infections (OR = 3.4, p = 0.009), hemoglobin level (OR = 0.04, p < 0.001), tracheostomy
(OR = 5.34, p = 0.004), and blood transfusion (OR = 0.168, p = 0.001). The overall
mortality rate associated with ICU-acquired CLABSIs was 70.1 deaths per 1,000 adult
ICU patients with CVC, and the case fatality rate was 77.6%. ICU-acquired CLABSIs
added 17.5 days to the hospital length of stay. Additional healthcare costs were estimated
as high as 3,308 Omani Rial per case of ICU-acquired CLABSIs.
Conclusion: The current study found that the prevalence of ICU-acquired CLABSIs in
Oman is considerably higher than the rates reported for developed countries.
Furthermore, the current study revealed that there are some modifiable risk factors among
the different risk factors associated with ICU-acquired CLABSIs in Oman. Moreover,
this study was able to approximate the economic burden associated with ICU-acquired
CLABSIs. The estimated figure can be used to predict healthcare costs saving achieved
after implementing interventions to reduce ICU-acquired CLABSIs. Finally, the findings
provide strong evidence for the need of implementing a bundle of care, following the
updated international guidelines suggested by the World Health Organization and the
CDC to prevent ICU-acquired CLABSIs.
