Central Line-Associated Bloodstream Infections in the Intensive Care Unit: A Narrative Review of the Multidisciplinary Synthesis of Radiologic Confirmation, Microbial Epidemiology, Nursing Stewardship, and Patient-Centered Outcomes
Abstract
Background: Central line-associated bloodstream infections (CLABSIs) represent a significant cause of morbidity, mortality, and increased healthcare costs in intensive care unit (ICU) patients. While substantial literature exists on prevention bundles and microbiological surveillance, the critical interface between radiology and nursing in the comprehensive management of central venous catheters remains underexplored. Aim: This narrative review synthesizes current evidence on the multidisciplinary management of CLABSIs in the ICU, with particular focus on the integration of radiologic confirmation of line placement, microbial epidemiology, nursing prevention strategies, and patient-centered care. Methods: A comprehensive literature search was conducted using PubMed, CINAHL, Cochrane Library, and CDC databases for articles published between 2010 and 2024. Results: Radiologic confirmation of central line placement using portable chest x-ray remains the standard for verifying tip position at the cavoatrial junction and ruling out pneumothorax, though emerging evidence supports ultrasound-based confirmation. The predominant pathogens include coagulase-negative staphylococci (12.5-31%), Staphylococcus aureus (6.3-16%), Enterococci, and Candida species, with increasing antimicrobial resistance. Nursing interventions, particularly standardized care bundles incorporating chlorhexidine bathing, dressing protocols, and daily line necessity assessments, reduce CLABSI rates by 21-68%.…
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