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

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

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254 Antibiogram Does Not Predict Escherichia Coli Resistance to Ciprofloxacin in Women Presenting With Uncomplicated Urinary Tract Infection to an Urban, Academic Medical Center Emergency Department: A Prospective, Observational Study

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2014.07.281 ◽

2014 ◽

Vol 64 (4) ◽

pp. S91

Author(s):

T. Al-Salamah ◽

M.C. Hines ◽

B. Hayes ◽

E. Heil ◽

M. Witting ◽

...

Keyword(s):

Escherichia Coli ◽

Emergency Department ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Prospective Observational Study ◽

Medical Center ◽

Academic Medical Center ◽

Uncomplicated Urinary Tract Infection ◽

Academic Medical

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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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2018.78 ◽

2018 ◽

Vol 39 (07) ◽

pp. 878-880 ◽

Cited By ~ 1

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

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