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. 2013 Jun;34(6):547-54.
doi: 10.1086/670629. Epub 2013 Apr 18.

National estimates of central line-associated bloodstream infections in critical care patients

Matthew E Wise  1 , R Douglas Scott 2nd, James M Baggs, Jonathan R Edwards, Katherine D Ellingson, Scott K Fridkin, L Clifford McDonald, John A Jernigan
Affiliations

National estimates of central line-associated bloodstream infections in critical care patients

Matthew E Wise et al. Infect Control Hosp Epidemiol. 2013 Jun.

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. U.S. 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 U.S. 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.

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Conflict of interest statement

Potential conflicts of interest. All authors report no conflicts of interest relevant to this article. All authors submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and the conflicts that the editors consider relevant to this article are disclosed here.

Figures

FIGURE 1
FIGURE 1
Estimated annual number of national critical care patient-days, excluding neonates, by acute care hospital type, United States, 1990–2010.
FIGURE 2
FIGURE 2
Annual distribution of critical care patient-days reported to the National Nosocomial Infections Surveillance and National Healthcare Safety Network systems (A) and estimated annual distribution of national critical care patient-days (B), excluding neonates, by acute care hospital type, United States, 1990–2010.
FIGURE 3
FIGURE 3
Hospital-onset central line-associated bloodstream infection (CLABSI) rates (cases per 1,000 critical care patient-days) adjusted for CLABSI definition change, surveillance participation changes, and system transition, excluding neonates, United States, 1990–2010.
See this image and copyright information in PMC

Comment in

  • When counting central line infections counts.
    Dixon-Woods M, Perencevich EN. Dixon-Woods M, et al. Infect Control Hosp Epidemiol. 2013 Jun;34(6):555-7. doi: 10.1086/670630. Epub 2013 Apr 18. Infect Control Hosp Epidemiol. 2013. PMID: 23651884 No abstract available.

References

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MeSH terms