A nationwide study led by AIIMS, New Delhi, has found that bloodstream infections linked to catheter use remain widespread across Indian intensive care units, underscoring gaps in infection prevention and the growing challenge of antimicrobial resistance.
Bloodstream infections contracted during hospital stays due to central line catheter use are prevalent in intensive care units (ICUs) across India and are often caused by microbes resistant to antibiotics. The findings, from a study led by the All India Institute of Medical Sciences (AIIMS) and published in The Lancet Global Health, raise concerns about patient safety, healthcare costs, and systemic pressures in a resource-constrained environment.
According to The Economic Times, the study analysed data from 200 ICUs across 54 hospitals in India collected between May 2017 and April 2024 through the Indian Healthcare-Associated Infections (HAI) surveillance network. Over this period, researchers recorded 8,629 confirmed cases of central line-associated bloodstream infections (CLABSI), spanning more than three million patient-days and nearly one million central line-days. The overall pooled CLABSI rate was 8.83 per 1,000 central line-days.
CLABSI events occur when a central venous catheter, typically inserted for critically ill patients, becomes a conduit for infection. While preventable with proper hygiene and monitoring protocols, such infections contribute significantly to morbidity, mortality, and extended hospitalisation, particularly in low- and middle-income countries. In India, these infections represent both a clinical and economic burden, driving up treatment costs and lengthening recovery times.
The study noted the highest incidence of CLABSI during 2020–21, coinciding with the COVID-19 pandemic. Overwhelmed hospitals, shortages of trained staff, and compromised infection prevention practices during peak pandemic waves were cited as contributing factors. This reflects how systemic stress can directly impact infection control outcomes, offering lessons for resilience planning in future public health crises.
Antimicrobial resistance (AMR) emerged as a central concern in the study. Many CLABSI cases involved pathogens resistant to multiple antibiotics, limiting treatment options and necessitating more expensive or less effective alternatives. For healthcare administrators and policymakers, this underscores the urgency of aligning infection control with AMR stewardship initiatives already underway at the national level.
Researchers highlighted that consistent tracking of CLABSI rates could enable hospitals to implement targeted preventive measures, from stricter line insertion protocols to staff training in aseptic techniques. However, they also noted the challenge of building surveillance systems in low-resource settings, where infrastructure and personnel limitations hinder systematic monitoring.
As the first large-scale observational study to provide standardised national data on CLABSI in India, the findings create an opportunity for quality improvement frameworks. Hospitals and regulators may leverage this data to establish benchmarks, assess performance, and design cost-effective interventions. For private providers, particularly those managing large tertiary care networks, the results may influence investments in infection control technology and workforce training.
The study’s implications extend beyond clinical outcomes, with relevance for insurers, investors, and policymakers seeking to strengthen India’s healthcare system. Reducing CLABSI rates could lower patient costs, free up ICU capacity, and align with broader public health goals around AMR containment. As the burden of hospital-acquired infections comes into sharper focus, the next step lies in translating surveillance into action.
