{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:10:23Z","timestamp":1779196223464,"version":"3.51.4"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean Society for Healthcare-associated Infection and Prevention"},{"name":"Chung-Ang University Research Grants"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Central line-associated bloodstream infection (CLABSI) remains a major healthcare-associated infection in intensive care units (ICUs). This study evaluated changes in CLABSI incidence following the implementation of a multimodal infection control intervention in the ICU. Methods: We conducted a quasi-experimental study in the adult ICUs of a referral hospital from January 2023 to December 2025. The interventions included staff education, performance feedback, infection control-led rounds, optimization of catheter practices, and reinforcement of environmental hygiene. The primary outcome was CLABSI incidence per 1000 central line-days. An interrupted time-series analysis using segmented Poisson regression with robust standard errors was used to assess temporal trends. Results: A total of 17 CLABSI cases occurred during the pre-intervention period, and 25 during the post-intervention period. There was no significant difference in CLABSI incidence between the two periods (incidence rate ratio, 1.07; 95% confidence interval, 0.58\u20131.98). However, interrupted time-series analysis demonstrated a significant decreasing trend in CLABSI incidence following the intervention (rate ratio, 0.89 per month; 95% confidence interval, 0.81\u20130.97; p = 0.01). This trend was observed despite the higher patient severity and increased use of advanced supportive therapies in the post-intervention period. The device utilization ratio and monthly blood culture rate remained unchanged. Avoidance of femoral venous access increased, and adherence to catheter-handling protocols significantly improved. Conclusions: A staged, multimodal intervention was associated with a significant decreasing trend in CLABSI incidence over time, suggesting a potential benefit of comprehensive infection prevention strategies in ICU settings.<\/jats:p>","DOI":"10.3390\/antibiotics15050504","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:53:10Z","timestamp":1779191590000},"page":"504","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a Multimodal Infection Control Intervention on Central Line-Associated Bloodstream Infections in the ICU"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4447-975X","authenticated-orcid":false,"given":"Hyemin","family":"Chung","sequence":"first","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Insoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-9573","authenticated-orcid":false,"given":"Kye Won","family":"Choe","sequence":"additional","affiliation":[{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Department of Laboratory Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6274-1790","authenticated-orcid":false,"given":"Moonsuk","family":"Bae","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joung Ha","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oh Joo","family":"Kweon","sequence":"additional","affiliation":[{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Department of Laboratory Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4410-5608","authenticated-orcid":false,"given":"Min-Chul","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea"},{"name":"Infection Control Office, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si 14353, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1056\/NEJMhpr020557","article-title":"Infection Control\u2014A Problem for Patient Safety","volume":"348","author":"Burke","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"391","DOI":"10.7326\/0003-4819-132-5-200003070-00009","article-title":"Prevention of Intravascular Catheter\u2013related Infections","volume":"132","author":"Mermel","year":"2000","journal-title":"Ann. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ajic.2014.11.014","article-title":"National Healthcare Safety Network Report, Data Summary for 2013, Device-Associated Module","volume":"43","author":"Dudeck","year":"2015","journal-title":"Am. J. Infect. Control"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1086\/648439","article-title":"Central Line-Associated Bloodstream Infections in Limited-Resource Countries: A Review of the Literature","volume":"49","author":"Rosenthal","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1056\/NEJM199901073400109","article-title":"The Evolving Technology of Venous Access","volume":"340","author":"Wenzel","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1086\/497833","article-title":"Clinical and Economic Outcomes in Critically Ill Patients with Nosocomial Catheter-Related Bloodstream Infections","volume":"41","author":"Blot","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1097\/01.CCM.0000227648.15804.2D","article-title":"Attributable Cost of Catheter-Associated Bloodstream Infections among Intensive Care Patients in a Nonteaching Hospital","volume":"34","author":"Warren","year":"2006","journal-title":"Crit. Care Med."},{"key":"ref_8","unstructured":"(2022). Global Report on Infection Prevention and Control: Executive Summary, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e162","DOI":"10.1093\/cid\/cir257","article-title":"Guidelines for the Prevention of Intravascular Catheter-Related Infections","volume":"52","author":"Alexander","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1017\/ice.2022.87","article-title":"Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute-Care Hospitals: 2022 Update","volume":"43","author":"Buetti","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1056\/NEJMoa061115","article-title":"An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU","volume":"355","author":"Pronovost","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ajic.2009.08.017","article-title":"Effectiveness of a Catheter-Associated Bloodstream Infection Bundle in a Thai Tertiary Care Center: A 3-Year Study","volume":"38","author":"Apisarnthanarak","year":"2010","journal-title":"Am. J. Infect. Control"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s10096-010-0971-6","article-title":"Reduction in Catheter-Related Bloodstream Infections in Critically Ill Patients through a Multiple System Intervention","volume":"29","author":"Peredo","year":"2010","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1136\/bmjqs.2009.037200","article-title":"Elimination of Central-Venous-Catheter-Related Bloodstream Infections from the Intensive Care Unit","volume":"20","author":"Longmate","year":"2011","journal-title":"BMJ Qual. Saf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/CCM.0b013e318232e4f3","article-title":"Zero Risk for Central Line-Associated Bloodstream Infection: Are We There Yet?","volume":"40","author":"McLaws","year":"2012","journal-title":"Crit. Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S1473-3099(15)00480-6","article-title":"Central-Line Bundles Need a Multimodal Implementation Strategy","volume":"16","author":"Zingg","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.ajic.2017.08.032","article-title":"Leadership Line Care Rounds: Application of the Engage, Educate, Execute, and Evaluate Improvement Model for the Prevention of Central Line-Associated Bloodstream Infections in Children with Cancer","volume":"46","author":"Owings","year":"2018","journal-title":"Am. J. Infect. Control"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1136\/bmjqs-2014-003787","article-title":"Meta-Analysis of the Central Line Bundle for Preventing Catheter-Related Infections: A Case Study in Appraising the Evidence in Quality Improvement","volume":"25","year":"2016","journal-title":"BMJ Qual. Saf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/S1473-3099(15)00409-0","article-title":"Effectiveness of Insertion and Maintenance Bundles to Prevent Central-Line-Associated Bloodstream Infections in Critically Ill Patients of All Ages: A Systematic Review and Meta-Analysis","volume":"16","author":"Ista","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.ajic.2009.11.012","article-title":"Impact of a Program to Prevent Central Line-Associated Bloodstream Infection in the Zero Tolerance Era","volume":"38","author":"Marra","year":"2010","journal-title":"Am. J. Infect. Control"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jmii.2017.08.008","article-title":"Multimodal Interventions for Bundle Implementation to Decrease Central Line-Associated Bloodstream Infections in Adult Intensive Care Units in a Teaching Hospital in Taiwan, 2009\u20132013","volume":"51","author":"Lin","year":"2018","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.4065\/81.9.1159","article-title":"The Risk of Bloodstream Infection in Adults with Different Intravascular Devices: A Systematic Review of 200 Published Prospective Studies","volume":"81","author":"Maki","year":"2006","journal-title":"Mayo Clin. Proc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.amjmed.2014.01.001","article-title":"PICC-Associated Bloodstream Infections: Prevalence, Patterns, and Predictors","volume":"127","author":"Chopra","year":"2014","journal-title":"Am. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1086\/671737","article-title":"The Risk of Bloodstream Infection Associated with Peripherally Inserted Central Catheters Compared with Central Venous Catheters in Adults: A Systematic Review and Meta-Analysis","volume":"34","author":"Chopra","year":"2013","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s13756-022-01180-1","article-title":"Lower Risk of Bloodstream Infections for Peripherally Inserted Central Catheters Compared to Central Venous Catheters in Critically Ill Patients","volume":"11","author":"Pitiriga","year":"2022","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1001\/jama.286.6.700","article-title":"Complications of Femoral and Subclavian Venous Catheterization in Critically Ill Patients: A Randomized Controlled Trial","volume":"286","author":"Merrer","year":"2001","journal-title":"JAMA"},{"key":"ref_27","unstructured":"Korea Disease Control and Prevention Agency (2025). Annual Report of the Korean National Healthcare-Associated Infections Surveillance System (KONIS) 2023\u20132024."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/5\/504\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:28:55Z","timestamp":1779193735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/5\/504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["antibiotics15050504"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15050504","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]}}}