Catheter related bloodstream infection

A central venous catheter, while essential for long-term medication administration, fluid replacement, and blood draws, significantly increases the risk of infection. This risk escalates each time the closed blood system is compromised, such as during catheter insertion or maintenance. To minimize contamination, it is crucial that catheter insertion is conducted under sterile conditions, preferably within the controlled environment of an operating room.


Catheter-related bloodstream infection (CRBSI) is a serious complication that arises when bacteria or other microbes manage to infiltrate the bloodstream via the catheter. The surfaces of catheters are particularly susceptible to microbial colonization. Once colonized, these organisms can form a biofilm—a complex aggregation of microbes that adheres to the catheter’s surface. This biofilm acts as a protective shield for the bacteria, enhancing their resistance to antibiotics and increasing the difficulty of eradicating the infection. Effective management of CRBSI involves strict adherence to aseptic techniques during catheter handling and may require the use of antimicrobial-impregnated catheters or catheters coated with substances that repel bacterial attachment to reduce the incidence of these dangerous infections.

Where do the microbes come from?

The bacteria might come from the patient herself, for example, a local site infection is usually caused by the bacteria Staphylococcus aureus or coagulase-negative Staphylococci, which both occur on the skin and can be introduced during insertion, injection or infusion.

The bacteria can also come from external sources such as personnel or medical devices and accompany the catheter at insertion or be introduced via the blood to the catheter. Sometimes, the infection spreads to the bloodstream and leads to systemic infection.

Bacteria forming biofilm are much more resistant to the patient’s immune system and antibiotics.

Common symptoms of infection

  • Local infection: redness, swelling and/or sore skin around the insert. Warming or fluid formation from the insertion channel.
  • Systemic infection: fever and/or chills.

Prevention is key

Preventing Catheter-Related Bloodstream Infections (CRBSIs) is essential due to the severe consequences these infections have on patients, healthcare costs, and antibiotic use. CRBSIs not only result in prolonged hospital stays but also significantly elevate mortality rates, increase healthcare expenditures, and contribute to antibiotic resistance. The economic impact of CRBSIs is considerable, with the World Health Organization noting that the treatment for a single case can cost up to USD 56,000 (1,2). This figure reflects the extensive use of healthcare resources including longer hospitalization, additional diagnostic testing, and the need for intensive care. The mortality associated with CRBSIs is also notably high, estimated to be between 12 procent and 25 procent(3). The severe nature of these infections, their rapid progression to more serious conditions like sepsis, and the prevalence of underlying health issues in affected patients contribute to this high mortality rate.


1. Dimick JB et al. Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit. Arch Surg 2001;136:229–34.
2. Rello J, Ochagavia A, Sabanes E, et al. Evaluation of outcome of intravenous catheterrelated infections in critically ill patients. Am J Respir Crit Care Med 2000;162:1027–30.
3. Kluger DM, Maki DG. The relative risk of intravascular device related bloodstream infections in adults [Abstract]. In: Abstracts of the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Francisco, CA: American Society for Microbiology, 1999:514.