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Simplified Surveillance for Nosocomial Bloodstream Infections

Published online by Cambridge University Press:  02 January 2015

Deborah S. Yokoe ,
Jane Anderson ,
Robert Chambers ,
Maureen Connor ,
Robert Finberg ,
Cyrus Hopkins ,
Deborah Lichtenberg ,
Susan Marino ,
Dorothy McLaughlin  and
Edward O'Rourke
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Deborah S. Yokoe*
Affiliation:
Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Jane Anderson
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Robert Chambers
Affiliation:
Department of Medicine, Brockton and West Roxbury Veterans' Administration Medical Center, West Roxbury, Massachusetts
Maureen Connor
Affiliation:
Laboratory of Infectious Diseases, Dana-Farber Cancer Institute, Boston, Massachusetts
Robert Finberg
Affiliation:
Laboratory of Infectious Diseases, Dana-Farber Cancer Institute, Boston, Massachusetts
Cyrus Hopkins
Affiliation:
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Deborah Lichtenberg
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Susan Marino
Affiliation:
Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Dorothy McLaughlin
Affiliation:
Departments of Pediatrics and Infection Control, Children's Hospital, Boston, Massachusetts
Edward O'Rourke
Affiliation:
Departments of Pediatrics and Infection Control, Children's Hospital, Boston, Massachusetts
Matthew Samore
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Kenneth Sands
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Judith Strymish
Affiliation:
Department of Medicine, Brockton and West Roxbury Veterans' Administration Medical Center, West Roxbury, Massachusetts
Elise Tamplin
Affiliation:
Department of Medicine, Brockton and West Roxbury Veterans' Administration Medical Center, West Roxbury, Massachusetts
Nancy Vallonde
Affiliation:
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Richard Platt
Affiliation:
Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
*
181 Longwood Ave, Boston, MA 02115; e-mail, deborah.yokoe@channing.harvard.edu.
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Abstract

Objective:

To compare a surveillance definition of nosocomial bloodstream infections requiring only microbiology data to the Centers for Disease Control and Prevention's (CDC) current definition.

Setting:

Six teaching hospitals.

Methods:

We classified a representative sample of 73 positive blood cultures from six hospitals growing common skin contaminant isolates using a definition for bacteremia requiring only microbiology data and the CDC definition for primary bloodstream infection (National Nosocomial Infections Surveillance [NNIS] System review method). The classifications assigned during routine prospective surveillance also were noted, and the time required to classify isolates by the two methods was compared.

Results:

Among 65 blood cultures growing common skin contaminant isolates obtained from adults, the agreement rate between the microbiology data method and the NNIS review method was 91%. Agreement was significantly poorer for the eight blood cultures growing common skin contaminant isolates obtained from pediatric patients. The microbiology data method requires approximately 20 minutes less time per isolate than does routine surveillance.

Conclusions:

A definition based on microbiology data alone yields the same result as the CDC's definition in the large majority of instances. It is more resource-efficient than the CDC's current definition

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 9 , September 1998 , pp. 657 - 660
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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