{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:27:55Z","timestamp":1785306475189,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Central line-associated bloodstream infections (CLABSIs) remain a leading healthcare-associated infection in intensive care units (ICUs), yet independent risk factors and evidence-based catheter duration thresholds have not been defined through analytical study designs in settings with endemic multidrug-resistant organisms (MDROs). Methods: A retrospective case\u2013control study was conducted in the ICU of a tertiary teaching university hospital in western T\u00fcrkiye (January 2019\u2013December 2024). Cases (n = 74) were patients with confirmed CLABSIs per CDC\/NHSN criteria; controls (n = 148) were randomly selected central venous catheter (CVC)-bearing patients without CLABSIs. A reduced multivariate logistic regression model (seven variables; events-per-variable ratio 10.6) identified independent risk factors. Results: In multivariate analysis, catheter duration (adjusted OR: 1.19 per day; 95% CI: 1.13\u20131.24; p &lt; 0.001), renal replacement therapy (aOR: 3.66; 95% CI: 1.68\u20137.95; p = 0.001), vasopressor support (aOR: 3.04; 95% CI: 1.50\u20136.17; p = 0.002), APACHE-II score (aOR: 1.07 per point; 95% CI: 1.02\u20131.11; p = 0.002), lower Glasgow Coma Scale (aOR: 0.86 per point; 95% CI: 0.78\u20130.94; p = 0.002), mechanical ventilation (aOR: 2.48; 95% CI: 1.24\u20134.95; p = 0.010), and total parenteral nutrition (aOR: 2.33; 95% CI: 1.12\u20134.86; p = 0.024) were independently associated with CLABSI. The model demonstrated good discrimination (C-statistic: 0.864) and calibration (Hosmer\u2013Lemeshow p = 0.425). Kaplan\u2013Meier analysis showed CLABSI-free survival declining from 98.9% at day 7 to 42.9% at day 21 (log-rank p &lt; 0.001); these within-study estimates reflect relative risk patterns given the artificial 1:2 case-to-control ratio. Receiver operating characteristic (ROC) analysis identified day 13 as an exploratory optimal cutoff (AUC: 0.818; 95% CI: 0.762\u20130.874; sensitivity: 77.0%; specificity: 74.3%). CLABSI-attributable ICU mortality was 20.3% (47.3% vs. 27.0%; p = 0.004). Late-onset CLABSIs (&gt;10 days) were dominated by Gram-negative pathogens (68.3%) versus 35.7% in early-onset infections (Fisher\u2019s exact p = 0.012), with Acinetobacter baumannii as the predominant organism (27.0%; 83.3% carbapenem-resistant). Conclusions: Each additional catheter-day is independently associated with a 19% increment in CLABSI odds, with an exploratory critical threshold at day 13 beyond which enhanced surveillance measures should be considered, pending external validation.<\/jats:p>","DOI":"10.3390\/antibiotics15040407","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T11:53:46Z","timestamp":1776426826000},"page":"407","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Catheter Duration Threshold and Risk Factors for Central Line-Associated Bloodstream Infections in a Tertiary ICU with Endemic Carbapenem Resistance: A Case\u2013Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4425-5649","authenticated-orcid":false,"given":"Enes","family":"Dalmano\u011flu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bal\u0131kesir University, 10145 Bal\u0131kesir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet \u00d6zg\u00fcr","family":"\u00d6zhan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, Bal\u0131kesir University, 10145 Bal\u0131kesir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00fclent","family":"Atik","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, Bal\u0131kesir University, 10145 Bal\u0131kesir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-0712","authenticated-orcid":false,"given":"T\u00fclin","family":"Akarsu Ayazo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit (ICU), Faculty of Medicine, Bal\u0131kesir University, 10145 Bal\u0131kesir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/S2213-2600(14)70061-X","article-title":"Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations (ICON) audit","volume":"2","author":"Vincent","year":"2014","journal-title":"Lancet Respir. 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