Probabilistic Measurement of Central Line–Associated Bloodstream Infections. (14th December 2015)

• Record Type: Journal Article
• Authors: Hota, Bala; Malpiedi, Paul; Fridkin, Scott K.; Martin, John; Trick, William
• Is Part Of: Infection control and hospital epidemiology. Volume 37:Number 2(2016)
• Page Start: 149
• Page End: 155
• Publication Date: 2015-12-14
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.255
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : OBJECTIVE: To develop a probabilistic method for measuring central line–associated bloodstream infection (CLABSI) rates that reduces the variability associated with traditional, manual methods of applying CLABSI surveillance definitions. DESIGN: Multicenter retrospective cohort study of bacteremia episodes among patients hospitalized in adult patient-care units; the study evaluated presence of CLABSI. SETTING: Hospitals that used SafetySurveillor software system (Premier) and who also reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN). PATIENTS: Patients were identified from a stratified sample from all eligible blood culture isolates from all eligible hospital units to generate a final set with an equal distribution (ie, 20%) from each unit type. Units were divided a priori into 5 major groups: medical intensive care unit, surgical intensive care unit, medical-surgical intensive care unit, hematology unit, or general medical wards. INTERVENTIONS: Episodes were reviewed by 2 experts, and a selection of discordant reviews were re-reviewed. Data were joined with NHSN data for hospitals for in-plan months. A predictive model was created; model performance was assessed using the c statistic in a validation set and comparison with NHSN reported rates for in-plan months. RESULTS: A final model was created with predictors of CLABSI. The c statistic for the final model was 0.75 (0.68–0.80). Rates from regression modeling correlated better with expert review than NHSN-reported rates. CONCLUSIONS: The use of a regression model based on the clinical characteristics of the bacteremia outperformed traditional infection preventionist surveillance compared with an expert-derived reference standard. Infect. Control Hosp. Epidemiol. 2016;37(2):149–155