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National Estimates of Central Line–Associated Bloodstream Infections in Critical Care Patients

Published online by Cambridge University Press:  02 January 2015

Matthew E. Wise ,
R. Douglas Scott II ,
James M. Baggs ,
Jonathan R. Edwards ,
Katherine D. Ellingson ,
Scott K. Fridkin ,
L. Clifford McDonald  and
John A. Jernigan
Matthew E. Wise*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
R. Douglas Scott II
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
James M. Baggs
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Jonathan R. Edwards
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Katherine D. Ellingson
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Scott K. Fridkin
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
L. Clifford McDonald
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
John A. Jernigan
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, MS A-38, Atlanta, GA 30333 (CXX4@cdc.gov).
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Abstract

Objective.

Recent studies have demonstrated that central line-associated bloodstream infections (CLABSIs) are preventable through implementation of evidence-based prevention practices. Hospitals have reported CLABSI data to the Centers for Disease Control and Prevention (CDC) since the 1970s, providing an opportunity to characterize the national impact of CLABSIs over time. Our objective was to describe changes in the annual number of CLABSIs in critical care patients in the United States.

Design.

Monte Carlo simulation.

Setting.

US acute care hospitals.

Patients.

Nonneonatal critical care patients.

Methods.

We obtained administrative data on patient-days for nearly all US hospitals and applied CLABSI rates from the National Nosocomial Infections Surveillance and the National Healthcare Safety Network systems to estimate the annual number of CLABSIs in critical care patients nationally during the period 1990–2010 and the number of CLABSIs prevented since 1990.

Results.

We estimated that there were between 462,000 and 636,000 CLABSIs in nonneonatal critical care patients in the United States during 1990–2010. CLABSI rate reductions led to between 104,000 and 198,000 fewer CLABSIs than would have occurred if rates had remained unchanged since 1990. There were 15,000 hospital-onset CLABSIs in nonneonatal critical care patients in 2010; 70% occurred in medium and large teaching hospitals.

Conclusions.

Substantial progress has been made in reducing the occurrence of CLABSIs in US critical care patients over the past 2 decades. The concentration of critical care CLABSIs in medium and large teaching hospitals suggests that a targeted approach may be warranted to continue achieving reductions in critical care CLABSIs nationally.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 6 , June 2013 , pp. 547 - 554
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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