Central line-associated bloodstream infection surveillance outside the intensive care unit

A multicenter survey

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

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)869-874
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume33
Issue number9
DOIs
StatePublished - Sep 1 2012

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Intensive Care Units
Infection
Centers for Disease Control and Prevention (U.S.)
Patient Care
Catheters
Health Facility Size
Benchmarking
Tertiary Healthcare
Surveys and Questionnaires
Tertiary Care Centers
Inpatients
Demography
Delivery of Health Care
Equipment and Supplies

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Son, C. H., Daniels, T. L., Eagan, J. A., Edmond, M. B., Fishman, N. O., Fraser, T. G., ... Sepkowitz, K. A. (2012). Central line-associated bloodstream infection surveillance outside the intensive care unit: A multicenter survey. Infection Control and Hospital Epidemiology, 33(9), 869-874. https://doi.org/10.1086/667378

Central line-associated bloodstream infection surveillance outside the intensive care unit : A multicenter survey. / Son, Crystal H.; Daniels, Titus L.; Eagan, Janet A.; Edmond, Michael B.; Fishman, Neil O.; Fraser, Thomas G.; Kamboj, Mini; Maragakis, Lisa L.; Mehta, Sapna A.; Perl, Trish M.; Phillips, Michael S.; Price, Connie S.; Talbot, Thomas R.; Wilson, Stephen J.; Sepkowitz, Kent A.

In: Infection Control and Hospital Epidemiology, Vol. 33, No. 9, 01.09.2012, p. 869-874.

Research output: Contribution to journalArticle

Son, CH, Daniels, TL, Eagan, JA, Edmond, MB, Fishman, NO, Fraser, TG, Kamboj, M, Maragakis, LL, Mehta, SA, Perl, TM, Phillips, MS, Price, CS, Talbot, TR, Wilson, SJ & Sepkowitz, KA 2012, 'Central line-associated bloodstream infection surveillance outside the intensive care unit: A multicenter survey', Infection Control and Hospital Epidemiology, vol. 33, no. 9, pp. 869-874. https://doi.org/10.1086/667378
Son, Crystal H. ; Daniels, Titus L. ; Eagan, Janet A. ; Edmond, Michael B. ; Fishman, Neil O. ; Fraser, Thomas G. ; Kamboj, Mini ; Maragakis, Lisa L. ; Mehta, Sapna A. ; Perl, Trish M. ; Phillips, Michael S. ; Price, Connie S. ; Talbot, Thomas R. ; Wilson, Stephen J. ; Sepkowitz, Kent A. / Central line-associated bloodstream infection surveillance outside the intensive care unit : A multicenter survey. In: Infection Control and Hospital Epidemiology. 2012 ; Vol. 33, No. 9. pp. 869-874.
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AU - Perl, Trish M.

AU - Phillips, Michael S.

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AU - Wilson, Stephen J.

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N2 - 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.

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