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Impact of NHSN-CDC Mucosal Barrier Injury Surveillance on Central-Line–Associated Bloodstream Infection Rates in HSCT

Published online by Cambridge University Press:  02 November 2020

Renata Fagnani
Affiliation:
State University of Campinas Hospital
Luis Gustavo Oliveira Cardoso
Affiliation:
State University of Campinas Hospital Luis Felipe Bachur, State University of Campinas Hospital
Christian Cruz Höfling
Affiliation:
State University of Campinas Hospital
Elisa Teixeira Mendes
Affiliation:
Pontifical Catholic University of Campinas (PUC Campinas), Center for Life Sciences
nio Trabasso
Affiliation:
Infectious Diseases Division, Internal Medicine Department, Faculty of Medical Sciences, State University of Campinas
Maria Luíza Moretti
Affiliation:
Infectious Diseases Division, Internal Medicine Department, Faculty of Medical Sciences, State University of Campinas
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Abstract

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Background: Bloodstream infection (BSI) is the most challenging conditions in patients who undergo hematopoietic stem cell transplantation (HSCT). These infections may be related to health care in cases of central-line–associated bloodstream infection (CLABSI) or to translocation secondary to mucosal barrier injury (MBI). In 2013, MBI surveillance was incorporated into the CDC NHSN. The aim was to increase the CLABSI diagnostic accuracy by proposing more effective preventive care measures. The objective of this study was to evaluate impact of the MBI surveillance on CLABSI incidence density in a Brazilian university hospital. Methods: The CLABSI incidence densities from the period before BMI surveillance (2007–2012) and the period after BMI surveillance was implemented (2013–2018) were analyzed and compared. Infections during the preintervention period were reclassified according to the MBI criterion to obtain an accurate CLABSI rate for the first period. The average incidence densities for the 2 periods were compared using the Student t test after testing for no autocorrelation (P > .05). Results: After reclassification, the preintervention period incidence density (10 infections per 1,000 patient days) was significantly higher than the postintervention period incidence density (6 infections per 1,000 patients day; P = .011) (Table 1). Therefore, the reclassification of nonpreventable infections (MBI) in the surveillance system made the diagnosis of CLABSI more specific. The hospital infection control service was able to introduce specific preventive measures related to the insertion and management of central lines in HSCT patient care. Conclusions: The MBI classification improved the CLABSI diagnosis, which upgraded central-line prevention measures, then contributed to the decrease of CLABSI rates in this high-risk population.

Funding: None

Disclosures: None

Type
Poster Presentations
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.