Healthcare-Associated Infections: Central Line Associated Bloodstream Infection (CLABSI)

Clinical Summary

• A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs enter the bloodstream through a central line (central venous catheter). CLABSIs can progress rapidly and are associated with significant morbidity and mortality. 
  
• Clinical presentation often includes fever and chills or signs of sepsis in a patient with a central line; diagnosis relies on clinical evaluation and laboratory testing (e.g., blood cultures) and assessment of the line as a potential source. Management includes prompt antibiotics and line management (removal or exchange when indicated). 
  
• Prevention is bundle-based: appropriate line insertion practices (maximal sterile barriers, skin antisepsis), optimal site selection, daily review of line necessity with prompt removal, and meticulous line maintenance. CDC provides CLABSI prevention guidance for healthcare settings. 
  
• In Tennessee, CLABSI is monitored as part of healthcare-associated infection surveillance and reporting through the CDC’s National Healthcare Safety Network (NHSN) for applicable facility types.

Clinical Info & Links

What It Is

A central line-associated bloodstream infection (CLABSI) is a serious infection that can happen when germs enter the bloodstream through a central line (also called a central venous catheter). Central lines are tubes placed in a large vein (often in the neck, chest, or groin) to give medicines/fluids or draw blood, and they can stay in place for weeks or months. 

Signs and Symptoms

Signs of a bloodstream infection can include fever and chills, and symptoms may worsen quickly. If a person with a central line develops sudden illness or signs of infection, they should be evaluated right away because bloodstream infections can be severe.

How It Spreads

CLABSI can occur when bacteria or other germs travel along the central line and enter the bloodstream—especially if the line is not inserted correctly or is not kept clean. These infections are most often linked to healthcare care processes and can occur in hospitals and other healthcare facilities.

Diagnosis & Treatment

Healthcare providers diagnose a bloodstream infection using clinical evaluation and laboratory testing (such as blood cultures). Treatment typically requires prompt antibiotics and medical management of the central line (for example, assessing whether the line should be removed or replaced), depending on the patient’s condition and lab results.

Reporting in Tennessee

In Tennessee, CLABSIs are reportable to the Tennessee Department of Health (TDH) through the National Healthcare Safety Network (NHSN), which supports statewide monitoring and prevention efforts.