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Preventing CLABSIs: Experimental Interventions and Opportunities for Diagnostic and Antimicrobial Stewardship in Solid Organ Transplant Patients

Castronova, Isabella A (2022) Preventing CLABSIs: Experimental Interventions and Opportunities for Diagnostic and Antimicrobial Stewardship in Solid Organ Transplant Patients. Master Essay, University of Pittsburgh.

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Central line-associated bloodstream infections (CLABSIs) are one of the deadliest healthcare-associated infections (HAIs) and are associated with mortality and longer hospital stays. One population that is at a higher risk of having a CLABSI is patients who have recently received solid organ transplants, due to their frequent hospital stays and immunocompromised status. Current best practices to avoid CLABSIs are sterile insertion techniques of central venous catheters, proper line maintenance and daily checks for central line necessity. However, for the most vulnerable patients, further measurements may need to be taken. This literature review examined four experimental interventions—compliance audits, antimicrobial coated/impregnated catheters, antimicrobial dressings and patches at line entry site, and CHG bathing—for ease of use, cost, ease of implementation, and overall CLABSI reduction. CHG bathing and CHG dressings were found to be the most effective in reducing CLABSI rates and were cost effective, but compliance audits may be the most crucial in facilities with uncontrolled CLABSIs, since adherence to best practice guides is necessary. Antimicrobial and diagnostic stewardship was also examined, as both practices play a critical role in reducing CLABSI rates, especially in solid organ transplant patients. Smart culturing to eliminate positives in the absence of true bloodstream infection, as well as prescribing antibiotics only when infectious signs and symptoms are present can all help decrease the risk of CLABSIs and overuse of antibiotics, which can be detrimental for immunosuppressed patients. Infection prevention in healthcare settings is very significant to public health, since reducing infections will not only decrease morbidity and mortality among patients but also reduce financial strain on healthcare systems. Implementing the right interventions, along with diagnostic and antimicrobial stewardship, can help reduce the rate of CLABSIs in healthcare settings and can keep patients safe.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Castronova, Isabella Aiac9@pitt.eduiac9
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairSnyder, Grahamsnydergm3@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberMartin, Eliseemm207@pitt.eduemm207UNSPECIFIED
Committee MemberMartinson, Jeremyjmartins@pitt.edujmartinsUNSPECIFIED
Date: 12 May 2022
Date Type: Completion
Number of Pages: 33
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 12 May 2022 17:40
Last Modified: 12 May 2022 17:40


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