LB-11. Central Line-Associated Bloodstream Infection Surveillance Outside of the Intensive Care Unit: Results of a Multi-Center Survey
Session: Poster Abstract Session: Late Breaker Posters
Saturday, October 22, 2011
Room: Poster Hall B1
Background: As central line-associated bloodstream infection (CLABSI) surveillance becomes more common in the non-ICU wards, hospitals need appropriate benchmark data for reference.

Method: In March 2011, we conducted a voluntary, 12-question survey to compile the experiences of 10 hospitals that are collecting non-ICU central line-associated bloodstream infection (“nCLABSI”) data in the general inpatient wards. Recipients provided demographic information, descriptions of surveillance history and methodology, as well as available rates.

Result: Nine centers with 10 hospitals returned the survey. Hospitals ranged in size from 238 to 1,400 beds with a median of 815 beds. All participants began collecting nCLABSI data in 2010 or earlier. Infection rates ranged from 0.2 to 4.2 infections per 1,000 catheter-days, with a median of 2.5, substantially higher than the National Healthcare Safety Network (NHSN) rate (1.1 per 1,000 line-days). A review of collection methods did not reveal an apparent reason for the higher rate. Every hospital uses standard CDC definitions to review charts. Most indicated that charts are reviewed by Infection Prevention Practitioners, and 4 indicated that physician epidemiologists also review. At 5 hospitals, catheter-days are collected by the ward nursing staff or a unit manager who counts patients with central lines on a daily basis. Other hospitals indirectly estimate the number of catheter-days from electronic orders for maintenance and blood draws from the central line (n=3) or directly using another automated method.

Conclusion: In our review of nCLABSI practices and rates from 9 centers, only 2 were at or below the 2009 pooled CLABSI rate for inpatient wards published by NHSN. Possible reasons may include differences in reporting of nCLABSI to the NHSN database depending on infection risk. National rates published by the NHSN are often used as benchmarks of performance in hospital quality and safety. However, there may be important methodological differences in nCLABSI data collection across U.S. hospitals that may limit generalizability. We recommend that the NHSN nCLABSI rate therefore be interpreted with caution by hospitals and policymakers until additional hospital-level validation can be performed.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Crystal Son, MPH1, Titus Daniels, MD, MPH2, Janet Eagan, RN, MPH3, Michael Edmond, MD, MPH4, Thomas G. Fraser, MD5, Mini Kamboj, MD6, Lisa Maragakis, MD, MPH7, Sapna A. Mehta, MD8, Trish Perl, MD, MSc, FIDSA9,10, Michael S. Phillips, MD11, Connie Price, MD12,13, Thomas Talbot, MD, MPH14, Stephen J. Wilson, MD, MPH15 and Kent A. Sepkowitz, MD, FIDSA3, (1)Infection Control, Memorial Sloan-Kettering Cancer Center, New York, NY, (2)Vanderbilt University School of Medicine, Nashville, TN, (3)Memorial Sloan Kettering Cancer Center, New York, NY, (4)Medical College of Virginia Commonwealth University, Richmond, VA, (5)The Cleveland Clinic Foundation, Cleveland, OH, (6)Memorial Sloan-Kettering Cancer Ctr., New York, NY, (7)Johns Hopkins University, Baltimore, MD, (8)New York University School of Medicine, New York, NY, (9)Johns Hopkins University School of Medicine, Baltimore, MD, (10)Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD, (11)Infection Control and Prevention, New York University Langone Medical Center, New York, NY, (12)Denver Health Medical Center, Denver, CO, (13)University of Colorado Health Sciences Center, Denver, CO, (14)Vanderbilt University Medical Center, Nashville, TN, (15)Medicine/Infectious Diseases, Weill Cornell Medical Center/ NewYork-Presbyterian Hospital, New York, NY

Disclosures:

C. Son, None

T. Daniels, None

J. Eagan, None

M. Edmond, None

T. G. Fraser, None

M. Kamboj, None

L. Maragakis, None

S. A. Mehta, None

T. Perl, None

M. S. Phillips, None

C. Price, None

T. Talbot, None

S. J. Wilson, None

K. A. Sepkowitz, Department of Defense: Investigator, Research grant

See more of: Late Breaker Posters
See more of: Poster Abstract Session

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.