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Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis

Infection volume 43, pages 29–36 (2015)Cite this article

Abstract

Purpose

To identify the attributable mortality of central line associated blood stream infections (CLABSI) through meta-analysis.

Methods

Meta-analysis of case control and cohort studies, matched and unmatched, that reported on mortality of patients with and without CLABSI was performed. MEDLINE, CENTRAL, CINAHL were searched. Non-interventional studies of all languages that reported mortality in patients with CLABSI were included. Data were extracted on patient population, study setting, design, diagnostic criteria for CLABSI, and mortality. Results from studies comparing mortality due to CLABSI were pooled using a random effects model with assessment of heterogeneity. Heterogeneity of studies was assessed with an I 2 statistic and a funnel plot was generated to assess for publication bias.

Results

Eighteen studies were included with 1,976 CLABSI cases. Of the included studies, 17 took place in intensive care unit settings, most involved a mixed population of medical and surgical patients, and ten were matched using an illness severity index. Our findings show an odds ratio of in hospital death associated with CLABSI as 2.75 (CI 1.86–4.07) and 1.51 (CI 1.08–2.09) in the subgroup of the ten matched studies. Those studies where greater than 30 % of CLABSI were attributed to coagulase-negative Staphylococcus had an odds ratio of death of 1.64 (95 % CI 1.02–2.65) compared with 4.71 (95 % CI 1.54–14.39).

Conclusions

CLABSI is associated with a significantly increased risk of death supporting the use of extensive efforts to reduce these infections.

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Acknowledgments

Thanks to Nestor Anguiano, MD for his assistance in translating Spanish language studies.

Conflict of interest

All authors report no conflicts of interest relevant to this article.

Author information

Affiliations

  1. William S. Middleton Memorial Veterans Hospital (NS), University of Wisconsin Medical School, Madison, WI, USA

    Matthew J. Ziegler, Daniela C. Pellegrini & Nasia Safdar

  2. Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Madison, WI, USA

    Matthew J. Ziegler, Daniela C. Pellegrini & Nasia Safdar

  3. University of Wisconsin Hospital and Clinics, 1685 Highland Avenue, Madison, WI, 53705, USA

    Nasia Safdar

Authors
  1. Matthew J. Ziegler
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  2. Daniela C. Pellegrini
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  3. Nasia Safdar
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Corresponding author

Correspondence to Nasia Safdar.

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Ziegler, M.J., Pellegrini, D.C. & Safdar, N. Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection 43, 29–36 (2015). https://doi.org/10.1007/s15010-014-0689-y

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  • DOI: https://doi.org/10.1007/s15010-014-0689-y

Keywords

  • Central line infection
  • Mortality
  • Intensive care unit
  • Nosocomial infection