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Central Line–Associated Bloodstream Infection Surveillance outside the Intensive Care Unit: A Multicenter Survey

Published online by Cambridge University Press:  02 January 2015

Crystal H. Son ,
Titus L. Daniels ,
Janet A. Eagan ,
Michael B. Edmond ,
Neil O. Fishman ,
Thomas G. Fraser ,
Mini Kamboj ,
Lisa L. Maragakis ,
Sapna A. Mehta  and
Trish M. Perl
...Show all authors
Crystal H. Son*
Affiliation:
Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York
Titus L. Daniels
Affiliation:
Department of Infection Control and Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Janet A. Eagan
Affiliation:
Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York
Michael B. Edmond
Affiliation:
Division of Infectious Disease, Virginia Commonwealth University Health System, Richmond, Virginia
Neil O. Fishman
Affiliation:
Division of Infectious Disease, University of Pennsylvania Health System, Philadelphia, Pennsylvania
Thomas G. Fraser
Affiliation:
Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio
Mini Kamboj
Affiliation:
Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York
Lisa L. Maragakis
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins University, Baltimore, Maryland
Sapna A. Mehta
Affiliation:
Division of Infectious Diseases, New York University Langone Medical Center, New York, New York
Trish M. Perl
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins University, Baltimore, Maryland
Michael S. Phillips
Affiliation:
Division of Infectious Diseases, New York University Langone Medical Center, New York, New York
Connie S. Price
Affiliation:
Division of Infectious Diseases, University of Colorado Health Sciences Center, Denver, Colorado
Thomas R. Talbot
Affiliation:
Department of Infection Control and Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Stephen J. Wilson
Affiliation:
Division of Infectious Diseases, Weill Cornell Medical College, New York, New York
Kent A. Sepkowitz
Affiliation:
Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York
*
1275 York Avenue, Mailbox 247, New York, NY 10065 (sonc@mskcc.org)
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Abstract

Objective.

The success of central line-associated bloodstream infection (CLABSI) prevention programs in intensive care units (ICUs) has led to the expansion of surveillance at many hospitals. We sought to compare non-ICU CLABSI (nCLABSI) rates with national reports and describe methods of surveillance at several participating US institutions.

Design and Setting.

An electronic survey of several medical centers about infection surveillance practices and rate data for non-ICU Patients.

Participants.

Ten tertiary care hospitals.

Methods.

In March 2011, a survey was sent to 10 medical centers. The survey consisted of 12 questions regarding demographics and CLABSI surveillance methodology for non-ICU patients at each center. Participants were also asked to provide available rate and device utilization data.

Results.

Hospitals ranged in size from 238 to 1,400 total beds (median, 815). All hospitals reported using Centers for Disease Control and Prevention (CDC) definitions. Denominators were collected by different means: counting patients with central lines every day (5 hospitals), indirectly estimating on the basis of electronic orders (n = 4), or another automated method (n = 1). Rates of nCLABSI ranged from 0.2 to 4.2 infections per 1,000 catheter-days (median, 2.5). The national rate reported by the CDC using 2009 data from the National Healthcare Surveillance Network was 1.14 infections per 1,000 catheter-days.

Conclusions.

Only 2 hospitals were below the pooled CLABSI rate for inpatient wards; all others exceeded this rate. Possible explanations include differences in average central line utilization or hospital size in the impact of certain clinical risk factors notably absent from the definition and in interpretation and reporting practices. Further investigation is necessary to determine whether the national benchmarks are low or whether the hospitals surveyed here represent a selection of outliers.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 9 , September 2012 , pp. 869 - 874
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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