Preventable Central Line Infections Linked To 40% Mortality In ICUs, Lancet Study Reports

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large multicentre analysis published in The Lancet has found that central line–associated bloodstream infections (CLABSIs) remain a serious and largely preventable threat in Indian intensive care units. Between May 2017 and April 2024, the surveillance network recorded 8,629 confirmed CLABSI cases from around 200 adult, paediatric and neonatal ICUs across 54 hospitals — a dataset that captures both public and private tertiary centres.

High infection rates — and high stakes

The pooled CLABSI rate in the study was 8.83 infections per 1,000 central line–days — roughly ten times higher than figures reported from comparable US datasets — and nearly 40% of patients with these infections died within 14 days. Newborns were the most affected group, followed by adults and children, reflecting the special vulnerability of neonatal intensive care settings.

Drug resistance makes treatment harder

Worryingly, many of the pathogens isolated were resistant to last-line antibiotics. The study reported extremely high carbapenem resistance among Acinetobacter baumannii and Klebsiella pneumoniae isolates — a pattern that leaves clinicians with far fewer effective options and is associated with worse outcomes. Fungal bloodstream infections also carried substantial short-term mortality. These findings echo nationwide trends showing rising antimicrobial resistance in hospital pathogens.

Why this is largely preventable

Central lines are medically essential for many critically ill patients but become infection conduits when insertion or maintenance practices lapse. International experience shows that strict adherence to basic infection-prevention bundles — hand hygiene, full barrier precautions during insertion, use of chlorhexidine skin antisepsis, sterile drapes, daily review of line necessity and prompt removal when no longer needed — can dramatically cut CLABSI rates. The Lancet study authors and infection-control experts point to gaps in training, staffing and consistent implementation as key drivers of the problem.

What needs to change

The path forward is not primarily technological: it requires stronger infection-prevention systems, antibiotic stewardship to slow resistance, routine surveillance and accountability structures within hospitals, and focused support for neonatal ICUs. Given the high mortality linked to these infections, scaling proven low-cost practices could prevent many deaths and ease the pressure on already strained critical-care services.