What Is Catheter-Related Bloodstream Infection and How to Prevent It

Understanding Catheter-Related Bloodstream Infections (CRBSI)

A catheter-related bloodstream infection (CRBSI) occurs when a patient with an intravascular catheter—or within 48 hours after its removal—develops bacteremia or fungemia. This condition is typically accompanied by clinical signs of infection such as fever (temperature >38°C), chills, or hypotension. Importantly, no other identifiable source of infection should be present, and microbiological testing must confirm that the organism cultured from the catheter tip matches the one found in blood samples.

Key Risk Factors Behind CRBSI

Human and procedural factors play a significant role in the development of CRBSI. One major contributor is inadequate hand hygiene by healthcare providers during catheter insertion or maintenance. Even minor lapses in sterilization techniques can introduce harmful pathogens into the bloodstream. Additionally, the type of catheter material used can influence biofilm formation, making certain materials more prone to microbial colonization.

Impact of Insertion Site and Patient Condition

The anatomical site where the catheter is placed also affects infection risk. For example, femoral lines carry a higher risk compared to subclavian or internal jugular placements due to increased bacterial load in groin areas. Moreover, patients with compromised skin integrity or weakened immune systems—such as those undergoing chemotherapy or living with chronic diseases—are at greater risk for developing infections once a catheter is inserted.

Effective Prevention Strategies for Healthcare Providers

Preventing CRBSI begins with implementing strict infection control protocols. During catheter insertion, clinicians should use maximal sterile barriers, including wearing caps, masks, sterile gowns, gloves, and using full-body drapes. This significantly reduces the chance of contamination from the environment or personnel.

Equally important is adherence to proper hand hygiene before and after any contact with the catheter site. Using alcohol-based sanitizers or thorough handwashing with soap and water remains a cornerstone of infection prevention.

Optimal Catheter Site Selection and Ongoing Monitoring

Selecting the most appropriate insertion site based on individual patient needs can lower infection rates. Whenever possible, upper central veins are preferred over lower extremity sites. After placement, daily assessment of the catheter is crucial—healthcare teams should evaluate whether continued use is medically necessary and check for early signs of inflammation, redness, or discharge at the insertion site.

In institutional settings, adopting evidence-based bundles—such as the CDC's "Central Line Bundle"—has been shown to dramatically reduce CRBSI incidence. These include hand hygiene, chlorhexidine skin antisepsis, optimal site selection, sterile barrier precautions, and daily review of line necessity with prompt removal when no longer needed.

Conclusion: A Proactive Approach Saves Lives

Catheter-related bloodstream infections are serious but largely preventable complications in modern healthcare. By understanding the contributing factors and rigorously applying best practices in catheter care, medical professionals can protect vulnerable patients, improve outcomes, and reduce hospital stays and costs associated with these avoidable infections.