Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries.

• Latin American central line-associated bloodstream infections (CLABSI) rates are higher than those of high income countries. • Our objective is to identify CLABSI rates and risk factors in Latin American intensive care units (ICUs). • Length of stay, duration of central line, femoral, arterial and jugular increase CLABSI risk. • Public hospital, and Medical-surgical ICU increase CLABSI risk. • PICC was not associated with risk for CLABSI. Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America. From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR). About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P <.0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P <.0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P <.0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P <.0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P <.0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P <.0001). PICC (aOR=1.25;95%CI=0.63-2.51; P =.52) was not associated with CLABSI risk. Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations. [ABSTRACT FROM AUTHOR]