Differentiating between CRBSIs and CLABSIs
Although the terms are often used interchangeably to describe intravascular device (IVD)–related bloodstream infections,
there are discrepancies between CRBSI and CLABSI that can be confusing. The confusion impacts clinicians and infection
preventionists when they are developing plans for measuring and eliminating bloodstream infections in patient populations.
CRBSI
is a rigorous clinical definition, defined by precise laboratory findings that identify the CVC as the source
of the BSI and, used to determine diagnosis, treatment, and possibly epidemiology of BSI in patients with a CVC.
It is not typically used for surveillance purposes and there is little data available for comparison. Typically, the term
CRBSI is more likely to be used in clinical research.
Using the CRBSI definition requires more resources than use of the CLABSI definition as hospitals must have the
capacity to correctly collect and label blood culture sets drawn from the CVC and a peripheral phlebotomy as well
as culturing the CVC segment/ tips. Typically this rigorous approach requires a research study and staff.
CLABSI
is a term used only for surveillance purposes to identify BSIs that occur in the population at risk (patients with
central lines). Use of this term and CDC’s National Healthcare Safety Network (NHSN) CLABSI definition may lead
to an overestimation of the infection rate compared to the use of the rigorous CRBSI criteria. Researchers have recently
highlighted the serious implications for organizations and individual clinicians when CLABSIs are misclassified.
6
Healthcare professionals need to understand the differences between the terms CRBSI and CLABSI and how they
are used by various agencies. The CDC distinguishes between the two in the following way