A 10-Year Review of Total Hospital- Onset ICU Bloodstream Infections at an Academic Medical Center

被引:11
作者
Civitarese, Anna M. [1 ]
Ruggieri, Eric [2 ]
Walz, J. Matthias [3 ]
Mack, Deborah Ann [4 ]
Heard, Stephen O. [3 ]
Mitchell, Michael [5 ]
Lilly, Craig M. [6 ,7 ,8 ]
Landry, Karen E. [8 ]
Ellison, Richard T., III [4 ,6 ,9 ]
机构
[1] Worcester Polytech Inst, Dept Biol & Biotechnol, Worcester, MA 01609 USA
[2] Coll Holy Cross, Dept Math & Comp Sci, Worcester, MA 01610 USA
[3] Univ Massachusetts, Sch Med, Dept Anesthesiol & Perioperat Med, 55 Lake Ave North, Worcester, MA 01655 USA
[4] UMass Mem Med Ctr, Infect Control Dept, Worcester, MA USA
[5] Univ Massachusetts, Dept Pathol, Sch Med, 55 Lake Ave North, Worcester, MA 01655 USA
[6] Univ Massachusetts, Dept Med, Sch Med, 55 Lake Ave North, Worcester, MA 01655 USA
[7] Univ Massachusetts, Grad Sch Biomed Sci, Sch Med, 55 Lake Ave North, Worcester, MA 01655 USA
[8] UMass Mem Hlth Care, Dept Crit Care Operat, Worcester, MA USA
[9] Univ Massachusetts, Sch Med, Dept Microbiol & Physiol Syst, 55 Lake Ave North, Worcester, MA 01655 USA
关键词
bacteremia; bloodstream infection; central line-associated bloodstream infection; hospital-onset bacteremia; ICU; nosocomial; SURGICAL SITE INFECTION; PROGRAM; HYPERGLYCEMIA; INTERVENTION; RATES; TIME; CARE;
D O I
10.1016/j.chest.2017.02.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BACKGROUND: The rates of central line-associated bloodstream infections (CLABSIs) in U.S. ICUs have decreased significantly, and a parallel reduction in the rates of total hospital-onset bacteremias in these units should also be expected. We report 10-year trends for total hospital-onset ICU-associated bacteremias at a tertiary-care academic medical center. METHODS: This was a retrospective analysis of all positive-result blood cultures among patients admitted to seven adult ICUs for fiscal year 2005 (FY2005) through FY2014 according to Centers for Disease Control and Prevention National Healthcare Safety Network definitions. The rate of change for primary and secondary hospital-onset BSIs was determined, as was the distribution of organisms responsible for these BSIs. Data from three medical, two general surgical, one combined neurosurgical/trauma, and one cardiac/cardiac surgery adult ICU were analyzed. RESULTS: Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1,000 patient days in FY2005 to 0.32/1,000 patient days in FY2014; an 85.0% decrease (P < .0001). Secondary BSIs also progressively decreased from 3.56/1,000 to 0.66/1,000 patient days; an 81.4% decrease (P < .0001). The decrease in BSI rates remained significant after controlling for the number of blood cultures obtained and patient acuity. CONCLUSIONS: An increased focus on reducing hospital-onset infections at the academic medical center since 2005, including multimodal multidisciplinary efforts to prevent central line-associated BSIs, pneumonia, Clostridium difficile disease, surgical site infections, and urinary tract infections, was associated with progressive and sustained decreases for both primary and secondary hospital-onset BSIs.
引用
收藏
页码:1011 / 1017
页数:7
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