Background: Central line-associated bloodstream infections (CLABSIs) are important device-associated infections among critically ill patients. The causative organisms and their antimicrobial susceptibility patterns vary between institutions. However, institution-specific data regarding bacterial CLABSIs among adult intensive care unit (ICU) patients in central India remain limited. This study evaluated the occurrence, bacterial profile, and antimicrobial susceptibility patterns of CLABSIs among clinically suspected adult ICU patients with central venous catheters (CVCs). Materials and methods: A prospective observational study was conducted in the adult ICU of Index Medical College Hospital and Research Centre, Indore, India, from January 2024 to December 2025. A total of 245 consecutively enrolled patients aged >18 years with a CVC in place for >48 hours and clinical suspicion of having a bloodstream infection were included. Blood specimens were obtained aseptically from peripheral veins and CVCs. Blood-culture bottles were processed using the BacT/ALERT 3D automated system, and positive cultures were subcultured onto blood agar and MacConkey agar. Bacterial isolates were presumptively identified using standard biochemical tests and further identified to the species level using the VITEK 2 Compact system. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc-diffusion method, while colistin susceptibility was determined by broth microdilution, and vancomycin minimum inhibitory concentration was determined by VITEK 2. Results were interpreted according to the CLSI 2024. Results: Among the 245 ICU patients included in the study, 35 (14.29%) were confirmed to have CLABSI, whereas 210 (85.71%) were CLABSI-negative. The overall CLABSI rate was 13.70 episodes per 1,000 catheter-days. Among positive cases, 23 (65.7%) were male and 12 (34.3%) were female. Most cases occurred in patients aged 61-80 years, and the Cardiac Care Unit had the highest positivity rate. Gram-negative bacilli (GNB) accounted for 26 (74.3%) isolates and Gram-positive cocci (GPC) accounted for nine (25.7%). Among GNB, Klebsiella pneumoniae comprised eight (22.9%) isolates, followed by Acinetobacter baumannii 7 (20.0%), Pseudomonas aeruginosa 5 (14.3%), Escherichia coli 5 (14.3%), and Proteus mirabilis 1 (2.9). Among GPC, Staphylococcus aureus accounted for 7 (20.0%) and Enterococcus faecalis 2 (5.7). GNB isolates showed resistance, including to carbapenems, but susceptibility to colistin. All GPC were susceptible to vancomycin, linezolid, teicoplanin, and rifampicin. Among seven Staphylococcus aureus isolates, four (57.1%%) were cefoxitin-resistant and were classified as methicillin-resistant Staphylococcus aureus. Conclusions: CLABSIs continue to be notable healthcare-associated infections among ICU patients with CVCs, affecting 35 (14.29%) of the 245 patients included in the study. The prevalence of multidrug-resistant Gram-negative bacteria, particularly Klebsiella pneumoniae and Acinetobacter baumannii, underscores the necessity for ongoing microbiological surveillance, ICU-specific antibiograms, stringent infection control measures, judicious empirical antibiotic therapy, antimicrobial stewardship, and prompt removal of superfluous central lines to mitigate the incidence of CLABSIs. They may support the development of local ICU-specific antibiograms and institutional infection-control and antimicrobial-stewardship policies.
Areeb et al. (Tue,) studied this question.