Impact of Changes to the National Healthcare Safety Network (NHSN) Definition on Catheter-Associated Urinary Tract Infection (CAUTI) Rates in Intensive Care Units at an Academic Medical Center

2017 ◽  
Vol 38 (5) ◽  
pp. 621-623 ◽  
Author(s):  
Sonali D. Advani ◽  
Rachael A. Lee ◽  
Mariann Schmitz ◽  
Bernard C. Camins
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Medical Center ◽  
Academic Medical Center ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Academic Medical

Definitional Change in NHSN CAUTI Was Associated with an Increase in CLABSI Events: Evaluation of a Large Health System

2017 ◽  
Vol 38 (06) ◽  
pp. 685-689 ◽  
Author(s):  
Mohamad G. Fakih ◽  
Clariecia Groves ◽  
Angelo Bufalino ◽  
Lisa K. Sturm ◽  
Ann L. Hendrich
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Health System ◽  
Central Line ◽  
Large Reduction ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Event Rates

BACKGROUND The National Healthcare Safety Network (NHSN) catheter-associated urinary tract infection (CAUTI) definition was revised as of January 2015 to exclude funguria and lower bacteriuria levels. We evaluated the effect of the CAUTI definition change on NHSN-defined central-line–associated bloodstream infection (CLABSI) outcomes. METHODS We compared CAUTI and CLABSI NHSN-defined outcomes for calendar years 2014 and 2015 in the adult intensive care units (ICUs) of a single large health system. Changes in the event rates, the associated organisms, and the standardized infection ratio (SIR) were evaluated. RESULTS The study included 137 adult ICUs from 65 hospitals. The CAUTI SIR dropped from 1.04 in 2014 to 0.58 in 2015 (−44.2%), while the CLABSI SIR increased from 0.36 in 2014 to 0.47 in 2015 (+30.6%). CAUTI rates dropped 44.8% from 2.09 to 1.15 events per 1,000 device days (P<.001). Gram-positive–associated CAUTI rates dropped 36.7% from 0.34 to 0.22 per 1,000 device days (P=.007). CLABSI rates increased 27.1% from 0.71 to 0.90 per 1,000 device days (P=.027). Candida-associated CLABSI increased by 91.1% from 0.104 to 0.198 per 1,000 device days (P=.012), and Enterococcus-associated CLABSI increased by 121.6% from 0.071 to 0.16 per 1,000 device days (P=.008). CONCLUSIONS The revised CAUTI definition led to a large reduction in CAUTI rates and, in turn, an increase in candidemia and enterococcemia cases classified as CLABSI events. These findings have important implications on the perceived successes or failures to eliminate both infections. Infect Control Hosp Epidemiol 2017;38:685–689

The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center

2018 ◽  
Vol 39 (07) ◽  
pp. 878-880 ◽  
Author(s):  
Sonali D. Advani ◽  
Rachael A. Lee ◽  
Martha Long ◽  
Mariann Schmitz ◽  
Bernard C. Camins
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Medical Center ◽  
Academic Medical Center ◽  
Bloodstream Infections ◽  
Central Line ◽  
Academic Medical ◽  
The Impact

The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. However, our rates remained unchanged in 2015 and further declined in 2016 with the implementation of new vascular-access guidelines.Infect Control Hosp Epidemiol 2018;878–880

scholarly journals Comparison of Catheter-associated Urinary Tract Infection Rates by Perineal Care Agents in Intensive Care Units

2010 ◽  
Vol 4 (3) ◽  
pp. 142-150 ◽  
Author(s):  
Ihnsook Jeong ◽  
Soonmi Park ◽  
Jae Sim Jeong ◽  
Duck Sun Kim ◽  
Young Sun Choi ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Infection Rates ◽  
Perineal Care
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