Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T00:49:31.725Z Has data issue: false hasContentIssue false
  • English
  • Français

Development of a Modified Surveillance Definition of Central Line–Associated Bloodstream Infections for Patients with Hematologic Malignancies

Published online by Cambridge University Press:  02 January 2015

Megan J. DiGiorgio ,
Cynthia Fatica ,
Mary Oden ,
Brian Bolwell ,
Mikkael Sekeres ,
Matt Kalaycio ,
Patti Akins ,
Christina Shane ,
Jacob Bako  and
Steven M. Gordon
...Show all authors
Megan J. DiGiorgio*
Affiliation:
Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio
Cynthia Fatica
Affiliation:
Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio
Mary Oden
Affiliation:
Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio
Brian Bolwell
Affiliation:
Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland, Ohio
Mikkael Sekeres
Affiliation:
Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland, Ohio
Matt Kalaycio
Affiliation:
Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland, Ohio
Patti Akins
Affiliation:
Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland, Ohio
Christina Shane
Affiliation:
Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland, Ohio
Jacob Bako
Affiliation:
Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio
Steven M. Gordon
Affiliation:
Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio
Thomas G. Fraser
Affiliation:
Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio
*
Desk HS1-285, 9500 Euclid Avenue, Cleveland, OH 44195 (digiorm@ccf.org)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To develop a modified surveillance definition of central line-associated bloodstream infection (mCLABSI) specific for our population of patients with hematologic malignancies to better support ongoing improvement efforts at our hospital.

Design.

Retrospective cohort study.

Patients.

Hematologic malignancies population in a 1,200-bed tertiary care hospital on a 22-bed bone marrow transplant (BMT) unit and a 22-bed leukemia unit.

Methods.

An mCLABSI definition was developed, and pathogens and rates were compared against those determined using the National Healthcare Safety Network (NHSN) definition.

Results.

By the NHSN definition the CLABSI rate on the BMT unit was 6.0 per 1,000 central line-days, and by the mCLABSI definition the rate was 2.0 per 1,000 line-days (P < .001). On the leukemia unit, the NHSN CLABSI rate was 14.4 per 1,000 line-days, and the mCLABSI rate was 8.2 per 1,000 line-days (P = .009). The top 3 CLABSI pathogens by the NHSN definition were Enterococcus species, Klebsiella species, and Escherichia coli. The top 3 CLABSI pathogens by the mCLABSI definition were coagulase-negative Staphylococcus (CONS), Pseudomonas aeruginosa, and Staphylococcus aureus. The difference in the incidence of CONS as a cause of CLABSI under the 2 definitions was statistically significant (P < .001).

Conclusions.

A modified surveillance definition of CLABSI was associated with an increase in the identification of staphylococci as the cause of CLABSIs, as opposed to enteric pathogens, and a decrease in CLABSI rates.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 9 , September 2012 , pp. 865 - 868
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–332.Google Scholar
2. Tunkel, AR, Sepkowitz, KA. Infections caused by viridans group streptococci in patients with neutropenia. Clin Infect Dis 2002;34:1524–1529.Google Scholar
3. Freifield, AG, Bow, EJ, Sepkowitz, KA, et al. Clinical practice guidelines for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 2011;52(4):e56–e93.10.1093/cid/cir073Google Scholar
4. Poutsiaka, DD, Munson, D, Price, LL, Chan, GW, Snydman, DR. Blood stream infection (BSI) and acute GVHD after hematopoietic SCT (HSCT) are associated. Bone Marrow Transplant 2011;46:300–307.10.1038/bmt.2010.112Google Scholar
5. Fraser, TG, Gordon, SM. CLABSI rates in immunocompromised patients: a valuable patient centered outcome? Clin Infect Dis 2011;52:1446–1450.Google Scholar
6. Tomlinson, D, Mermel, LA, Ethier, MC, Matlow, A, Gillmeister, B, Sung, L. Defining bloodstream infections related to central venous catheters in patients with cancer: a systematic review. Clin Infect Dis 2011;53(7):697–710.10.1093/cid/cir523Google Scholar
7. O'Grady, NP, Alexander, M, Burns, LA, et al; Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52(9):el62–el93.Google Scholar
8. Lin, MY, Hota, B, Khan, YM, et al. Quality of traditional surveillance for public reporting of nosocomial bloodstream infection rates. JAMA 2010;304:2035–2041.Google Scholar