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Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013

  • Lauren Epstein (a1) (a2), Isaac See (a1), Jonathan R. Edwards (a1), Shelley S. Magill (a1) and Nicola D. Thompson (a1)...



To determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line–associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN)


Descriptive analysis of 2013 NHSN data


Selected inpatient locations in acute care hospitals


A descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type.


From 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%.


An understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest.

Infect. Control Hosp. Epidemiol. 2015;37(1):2–7


Corresponding author

Address correspondence to Lauren Epstein, MD, MSc, Epidemic Intelligence Service, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road Mailstop A-16, Atlanta, Georgia 30329-4027 (


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PREVIOUS PRESENTATION: The results of this analysis were presented in part at ID Week 2014 Philadelphia, Pennsylvania, October 9, 2014. Abstract #1284.



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