scholarly journals Impact of removing mucosal barrier injury laboratory-confirmed bloodstream infections from central line–associated bloodstream infection rates in the National Healthcare Safety Network, 2014

2017 ◽  
Vol 45 (3) ◽  
pp. 321-323 ◽  
Author(s):  
Isaac See ◽  
Minn M. Soe ◽  
Lauren Epstein ◽  
Jonathan R. Edwards ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Central Line ◽  
Mucosal Barrier ◽  
Infection Rates ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Mucosal Barrier Injury

scholarly journals Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013

2015 ◽  
Vol 37 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Lauren Epstein ◽  
Isaac See ◽  
Jonathan R. Edwards ◽  
Shelley S. Magill ◽  
Nicola D. Thompson
Keyword(s):  
Acute Care ◽  
Descriptive Analysis ◽  
Bloodstream Infections ◽  
Central Line ◽  
Mucosal Barrier ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Mucosal Barrier Injury ◽  
The Impact ◽  
Clabsi Rate

OBJECTIVESTo determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line–associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN)DESIGNDescriptive analysis of 2013 NHSN dataSETTINGSelected inpatient locations in acute care hospitalsMETHODSA descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type.RESULTSFrom 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%.CONCLUSIONSAn understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest.Infect. Control Hosp. Epidemiol. 2015;37(1):2–7

Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infection: Results from a Field Test of a New National Healthcare Safety Network Definition

2013 ◽  
Vol 34 (8) ◽  
pp. 769-776 ◽  
Author(s):  
Isaac See ◽  
Martha Iwamoto ◽  
Kathy Allen-Bridson ◽  
Teresa Horan ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Acute Care ◽  
Field Test ◽  
Acute Care Hospitals ◽  
Field Testing ◽  
Hospital Staff ◽  
Mucosal Barrier ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Mucosal Barrier Injury

Objective.To assess challenges to implementation of a new National Healthcare Safety Network (NHSN) surveillance definition, mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI).Design.Multicenter field test.Setting.Selected locations of acute care hospitals participating in NHSN central line-associated bloodstream infection (CLABSI) surveillance.Methods.Hospital staff augmented their CLABSI surveillance for 2 months to incorporate MBI-LCBI: a primary bloodstream infection due to a selected group of organisms in patients with either neutropenia or an allogeneic hematopoietic stem cell transplant with gastrointestinal graft-versus-host disease or diarrhea. Centers for Disease Control and Prevention (CDC) staff reviewed submitted data to verify whether CLABSIs met MBI-LCBI criteria and summarized the descriptive epidemiology of cases reported.Results.Eight cancer, 2 pediatric, and 28 general acute care hospitals including 193 inpatient units (49% oncology/bone marrow transplant [BMT], 21% adult ward, 20% adult critical care, 6% pediatric, 4% step-down) conducted field testing. Among 906 positive blood cultures reviewed, 282 CLABSIs were identified. Of the 103 CLABSIs that also met MBI-LCBI criteria, 100 (97%) were reported from oncology/BMT locations. Agreement between hospital staff and CDC classification of reported CLABSIs as meeting the MBI-LCBI definition was high (90%; k= 0.82). Most MBI-LCBIs (91%) occurred in patients meeting neutropenia criteria. Some hospitals indicated that their laboratories' methods of reporting cell counts prevented application of neutropenia criteria; revised neutropenia criteria were created using data from field testing.Conclusions.Hospital staff applied the MBI-LCBI definition accurately. Field testing informed modifications for the January 2013 implementation of MBI-LCBI in the NHSN.

scholarly journals Impact of Catheter Management on Clinical Outcome in Adult Cancer Patients With Gram-Negative Bacteremia

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Johny Fares ◽  
Melissa Khalil ◽  
Anne-Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Mucosal Barrier ◽  
Central Venous ◽  
Gram Negative ◽  
Central Venous Catheter Removal ◽  
Mucosal Barrier Injury

Abstract Objective Gram-negative organisms have become a major etiology of bloodstream infections. We evaluated the effect of central venous catheter management on cancer patients with gram-negative bloodstream infections. Method We retrospectively identified patients older than 14 years with central venous catheters who were diagnosed with gram-negative bloodstream infections to determine the effect of catheter management on outcome. Patients were divided into 3 groups: Group 1 included patients with central line-associated bloodstream infections (CLABSI) without mucosal barrier injury and those whose infection met the criteria for catheter-related bloodstream infection; group 2 included patients with CLABSI with mucosal barrier injury who did not meet the criteria for catheter-related bloodstream infection; and group 3 included patients with non-CLABSI. Results The study included 300 patients, with 100 patients in each group. Only in group 1 was central venous catheter removal within 2 days of bloodstream infection significantly associated with a higher rate of microbiologic resolution at 4 days compared to delayed central venous catheter removal (3–5 days) or retention (98% vs 82%, P = .006) and a lower overall mortality rate at 3-month follow-up (3% vs 19%, P = .01). Both associations persisted in multivariate analyses (P = .018 and P = .016, respectively). Conclusions Central venous catheter removal within 2 days of the onset of gram-negative bloodstream infections significantly improved the infectious outcome and overall mortality of adult cancer patients with catheter-related bloodstream infections and CLABSI without mucosal barrier injury.

Impact of International Nosocomial Infection Control Consortium’s multidimensional approach on central line–associated bloodstream infection rates in Bahrain

2019 ◽  
Vol 21 (4) ◽  
pp. 481-489
Author(s):  
Safaa Alkhawaja ◽  
Nermeen Kamal Saeed ◽  
Victor Daniel Rosenthal ◽  
Sana Abdul-Aziz ◽  
Ameena Alsayegh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Multidimensional Approach ◽  
Infection Rates

Background: Central line–associated bloodstream infections are serious life-threatening infections in the intensive care unit setting. Methods: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line–associated bloodstream infection rates in Bahrain from January 2013 to December 2016, we conducted a prospective, before-after surveillance, cohort, observational study in one intensive care unit in Bahrain. During baseline, we performed outcome and process surveillance of central line–associated bloodstream infection on 2320 intensive care unit patients, applying Centers for Disease Control and Prevention’s National Healthcare Safety Network definitions. During intervention, we implemented IMA through ISOS, including (1) a bundle of infection prevention interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on central line–associated bloodstream infection rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the central line–associated bloodstream infection rate. Results: During baseline, 672 central line days and 7 central line–associated bloodstream infections were recorded, accounting for 10.4 central line–associated bloodstream infections per 1000 central line days. During intervention, 13,020 central line days and 48 central line–associated bloodstream infections were recorded. After the second year, there was a sustained 89% cumulative central line–associated bloodstream infection rate reduction to 1.2 central line–associated bloodstream infections per 1000 central line days (incidence density rate, 0.11; 95% confidence interval 0.1–0.3; p, 0.001). The average extra length of stay of patients with central line–associated bloodstream infection was 23.3 days, and due to the reduction of central line–associated bloodstream infections, 367 days of hospitalization were saved, amounting to a reduction in hospitalization costs of US$1,100,553. Conclusion: Implementing IMA was associated with a significant reduction in the central line–associated bloodstream infection rate in Bahrain.

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