Catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity and mortality in critical care units with an estimated 28,000 patients dying from this complication every year in the United States alone. However, this complication is largely preventable. Recent evidence shows that a process that incorporates evidence based guidelines from the Centers for Disease Control and Prevention (CDC), the Society of Critical Care Medicine, and others into a comprehensive safety-based program can virtually eliminate CRBSIs.

A formal definition of a CRBSI can be found through the CDC. The patient must have a central venous catheter in place at the time of the suspected infection and there must be no other identifiable source of infection present. Both the catheter and peripheral blood must grow the same organism while the catheter was in place. Proper culture of the catheter requires that the intradermal portion of the catheter be cultured, not the tip as is commonly and incorrectly done. If at all possible, the peripheral blood drawn should be at least 10 mL, drawn from two separate peripheral sites. Blood drawn through the suspect catheter is invalid unless it is done through a special protocol and the lab performs quantitative cultures. This is usually done only for certain permanent catheters such as Hohn and Hickman catheters and occasionally with special lines dedicated for hyperalimentation. Colony counts for regular central catheters that report >15 colony-forming units for the catheter are considered positive.