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March 25, 2009

Preventing Catheter-Related Bloodstream InfectionsThinking Outside the Checklist

JAMA. 2009;301(12):1285-1287. doi:10.1001/jama.2009.420

The medical care system is at a crossroads in the control of health care–associated infections. For years, the status quo has been defined by scattered local success stories but an overall failure to protect patients from largely preventable infections. These infections have enormous human and economic costs, with an estimated 100 000 deaths and $6.5 billion in excess expenditure annually in the United States alone1,2 and estimates of 1.4 million patients affected daily worldwide.3,4 Catheter-related bloodstream infection is a leading contributor to health care–associated infection. Approximately 80 000 catheter-related bloodstream infections occur annually in US intensive care units (ICUs) and are associated with as many as 24 000 patient deaths.5 Each of these infections is estimated to have a mean attributable cost of $18 000 and an associated excess hospital stay of 12 days per episode.6

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