Adam Dingli2, Prof. Leon Worth1,2, Stephanie Tanamas1, Michael Malloy1, Prof Deborah Friedman1,3
1VICNISS Coordinating Centre, Doherty Institute, Melbourne, Australia, 2University of Melbourne, Melbourne, Australia, 3Department of Infectious Diseases, University of Melbourne, Melbourne, Australia
Biography:
Professor Leon Worth is a clinician–researcher specialising in healthcare-associated infection surveillance and prevention, with particular emphasis on emerging infection threats and population-level risk. His work encompasses the development, implementation, and evaluation of evidence-based strategies, and informs national policy, education, and practice across acute and aged-care healthcare systems.
Abstract:
Introduction
Prevention and surveillance of central-line associated bloodstream infection (CLABSI) is a priority in Australian ICU settings. Despite the frequent use of central venous catheters outside of ICU, the burden and epidemiology of CLABSI in these settings has not been characterised. We sought to evaluate CLABSI rates and aetiology in non-ICU wards, and compare with Victorian ICU data.
Methods
CLABSI surveillance was undertaken voluntarily in non-ICU wards by Victorian health services between 2014 and 2025, utilising the Victorian Healthcare Associated Infection Surveillance System (VICNISS) CLABSI surveillance module, capturing CLABSI as well as bloodstream infections related to mucosal barrier injury (CLAMBI), in accordance with NHSN/CDC criteria. Retrospective analysis was performed to determine rates, pathogens, and antimicrobial resistance.
Results
Sixteen facilities participated in surveillance during the study period. 67 CLABSI events and 66,096 central line days were reported in non-ICU wards (predominantly haematology/oncology), corresponding to a CLABSI rate of 1.01/1000 CVC days. The contemporaneous ICU CLABSI rate was 0.50/1000 CVC days (IRR 0.32, 95% CI 0.19–0.53, p=0.000). The most frequent pathogens responsible for non-ICU CLABSI were: coagulase-negative Staphylococcus, Staphylococcus aureus, and Pseudomonas spp. A large burden of CLAMBI events (n=90) were also reported.
Conclusion
CLABSI rates outside of ICU are significantly higher than rates reported in ICU settings. Further, a substantive burden of CLABSI and CLAMBI events are observed in haematology/oncology populations. Surveillance is feasible, and successful ICU prevention bundles must now be evaluated to determine relevance to other specialised and immunocompromised populations.