1484. An analysis of hospital acquired bloodstream infection: How many cases can we prevent?
Session: Poster Abstract Session: HAI: Surveillance and Public Reporting
Friday, October 28, 2016
Room: Poster Hall

Background:

Hospital-acquired bloodstream infections (HA-BSIs) are associated with prolonged length of hospital stay, high mortality, and increased cost. In order to reduce HA-BSI, we need to evaluate which cases of HA-BSI are preventable, by analyzing the data in terms of affected organs or systems, not only in terms of microorganisms.

Methods:

We prospectively collected all BSI data from April 2015 to March 2016. Nosocomial positive blood cultures were defined as positive blood culture results after 48 hours from admission. Oh them, HA-BSI was defined as BSI after 48 hours from admission. HA-BSIs of various organs were categorized by infectious diseases doctors by referring to charts. We defined surgical site infections (SSI), ventilator associated events (VAE), pneumonia other than VAE (PNEU), catheter related urinary tract infections (CAUTIs), central line–associated bloodstream infections (CLABSI), and peripheral line-associated blood stream infections (PLABSI) as preventable HA-BSIs. Furthermore, we defined preventable HA-BSIs and contamination as preventable conditions.

Results:

Between April 1, 2015 and March 31, 2016, 12,394 blood cultures were obtained, 738 of which became positive. Two hundred eighty-six out of 738 cases were categorized as nosocomial positive blood cultures. Of all nosocomial positive blood cultures, 41 cases (14.3%) were considered to be contamination and the rest of 245 cases (85.7%) were classified as HA-BSIs. Among 245 HA-BSIs, 138 cases (56.3%) were preventable. The rank order of the preventable HA-BSIs was CLABSI, 72 cases (52.2 %); PLABSI, 28 cases (20.3%); CAUTI, 18 cases (13.0%); PNEU, 10 cases (7.2%); SSI, 7 cases (5.1%); and VAE, 3 cases (2.2%). If we consider contamination along with HA-BSIs, 179 of 286 (62.6%) nosocomial blood culture positive cases were preventable.

Conclusion:

We found that 56.3% of HA-BSIs were preventable and most of these were CLABSI and PLABSI. To reduce HA-BSIs, further efforts are needed to prevent CLABSI and PLABSI. We also need to reduce contamination to minimize the number of all preventable conditions.

 

Yuichi Katanami, M.D.1, Nozomi Takeshita, M.D., Ph.D.1, Kazuhisa Mezaki, M. T.2, Yoshikazu Mutoh, M.D1, Koh Shinohara, M.D.1, Motoyuki Tsuboi, M.D.1, Takehiro Hashimoto, M.D.1, Kei Yamamoto, M.D.1, Satoshi Kutsuna, M.D., Ph.D.1, Kayoko Hayakawa, M.D., Ph.D.1 and Norio Ohmagari, M.D., M.Sc., Ph.D.1, (1)Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan, (2)National Center for Global Health and Medicine, Tokyo, Japan

Disclosures:

Y. Katanami, None

N. Takeshita, None

K. Mezaki, None

Y. Mutoh, None

K. Shinohara, None

M. Tsuboi, None

T. Hashimoto, None

K. Yamamoto, None

S. Kutsuna, None

K. Hayakawa, None

N. Ohmagari, None

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