Document Detail


Central line-associated bloodstream infection surveillance outside the intensive care unit: a multicenter survey.
MedLine Citation:
PMID:  22869259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 ([Formula: see text]), or another automated method ([Formula: see text]). 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.
Authors:
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; Trish M Perl; Michael S Phillips; Connie S Price; Thomas R Talbot; Stephen J Wilson; Kent A Sepkowitz
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2012-07-24
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  33     ISSN:  1559-6834     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-07     Completed Date:  2012-12-27     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  869-74     Citation Subset:  IM; N    
Affiliation:
Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. sonc@mskcc.org
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MeSH Terms
Descriptor/Qualifier:
Catheter-Related Infections / epidemiology,  prevention & control*
Catheterization, Central Venous / adverse effects*
Cross Infection / epidemiology,  prevention & control*
Health Care Surveys
Hospitals, University / statistics & numerical data*
Hospitals, Urban / statistics & numerical data*
Humans
Infection Control / methods*,  statistics & numerical data
Tertiary Care Centers / statistics & numerical data*
United States
Grant Support
ID/Acronym/Agency:
K23 AI083880/AI/NIAID NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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