Skip to main content Accessibility help
×
Home
Hostname: page-component-564cf476b6-zvgck Total loading time: 0.232 Render date: 2021-06-21T11:33:20.796Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Central-line–Associated Bloodstream Infections Among Adult Intensive Care Unit Patients in Canadian Hospitals, 2011–2018

Published online by Cambridge University Press:  02 November 2020

Wallis Rudnick
Affiliation:
Public Health Agency of Canada
Lynn Johnston
Affiliation:
Nova Scotia Health Authority and Dalhousie University
Jocelyn A. Srigley
Affiliation:
BC Children's Hospital & BC Women's Hospital + Health Centre and Provincial Health Services Authority
Jun Chen Collet
Affiliation:
BC Children's Hospital & BC Women's Hospital + Health Centre
Jeannette Comeau
Affiliation:
IWK Health Centre and Dalhousie University
Chelsey Ellis
Affiliation:
Horizon Health Network and The Moncton Hospital
Charles Frenette
Affiliation:
McGill University Health Center
Bonita E. Lee
Affiliation:
Stollery Children's Hospital and University of Alberta
Joanne M. Langley
Affiliation:
IWK Health Centre and Dalhousie University
Marie-Astrid Lefebvre
Affiliation:
McGill University Health Centre
Allison McGeer
Affiliation:
Sinai Health System and University of Toronto
Jennifer Parsonage
Affiliation:
Alberta Health Services
Donna Penney
Affiliation:
Eastern Health, Western Health and IPAC Canada
Michelle Science
Affiliation:
The Hospital for Sick Children
Anada Silva
Affiliation:
Public Health Agency of Canada
Stephanie W. Smith
Affiliation:
University of Alberta and Alberta Health Services
Kathryn N. Suh
Affiliation:
The Ottawa Hospital
Linda Pelude
Affiliation:
Public Health Agency of Canada
CNISP PHAC
Affiliation:
Public Health Agency of Canada
Rights & Permissions[Opens in a new window]

Abstract

Background: Nosocomial central-line–associated bloodstream infections (CLABSIs) are an important cause of morbidity and mortality in hospitalized patients. CLABSI surveillance establishes rates for internal and external comparison, identifies risk factors, and allows assessment of interventions. Objectives: To determine the frequency of CLABSIs among adult patients admitted to intensive care units (ICUs) in CNISP hospitals and evaluate trends over time. Methods: CNISP is a collaborative effort of the Canadian Hospital Epidemiology Committee, the Association of Medical Microbiologists and Infectious Disease Canada and the Public Health Agency of Canada. Since 1995, CNISP has conducted hospital-based sentinel surveillance of healthcare-associated infections. Overall, 55 CNISP hospitals participated in ≥1 year of CLABSI surveillance. Adult ICUs are categorized as mixed ICUs or cardiovascular (CV) surgery ICUs. Data were collected using standardized definitions and collection forms. Line-day denominators for each participating ICU were collected. Negative-binomial regression was used to test for linear trends, with robust standard errors to account for clustering by hospital. We used the Fisher exact test to compare binary variables. Results: Each year, 28–42 adult ICUs participated in surveillance (27–37 mixed, 6–8 CV surgery). In both mixed ICUs and CV-ICUs, rates remained relatively stable between 2011 and 2018 (Fig. 1). In mixed ICUs, CLABSI rates were 1.0 per 1,000 line days in 2011, and 1.0 per 1,000 line days in 2018 (test for linear trend, P = .66). In CV-ICUs, CLABSI rates were 1.1 per 1,000 line days in 2011 and 0.8 per 1,000 line days in 2018 (P = .19). Case age and gender distributions were consistent across the surveillance period. The 30-day all-cause mortality rate was 29% in 2011 and in 2018 (annual range, 29%–35%). Between 2011 and 2018, the percentage of isolated microorganisms that were coagulase-negative staphylococci (CONS) decreased from 31% to 18% (P = .004). The percentage of other gram-positive organisms increased from 32% to 37% (P = .34); Bacillus increased from 0% to 4% of isolates and methicillin-susceptible Staphylococcus aureus from 2% to 6%). The gram-negative organisms increased from 21% to 27% (P = .19). Yeast represented 16% in 2011 and 18% in 2018; however, the percentage of yeast that were Candida albicans decreased over time (58% of yeast in 2011 and 30% in 2018; P = .04). Between 2011 and 2018, the most commonly identified species of microorganism in each year were CONS (18% in 2018) and Enterococcus spp (18% in 2018). Conclusions: Ongoing CLABSI surveillance has shown stable rates of CLABSI in adult ICUs from 2011 to 2018. The causative microorganisms have changed, with CONS decreasing from 31% to 18%.

Funding: CNISP is funded by the Public Health Agency of Canada.

Disclosures: Allison McGeer reports funds to her for studies, for which she is the principal investigator, from Pfizer and Merck, as well as consulting fees from Sanofi-Pasteur, Sunovion, GSK, Pfizer, and Cidara.

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

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Central-line–Associated Bloodstream Infections Among Adult Intensive Care Unit Patients in Canadian Hospitals, 2011–2018
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Central-line–Associated Bloodstream Infections Among Adult Intensive Care Unit Patients in Canadian Hospitals, 2011–2018
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Central-line–Associated Bloodstream Infections Among Adult Intensive Care Unit Patients in Canadian Hospitals, 2011–2018
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *