Faculty Collaboration Database

A 10-Year Review of Total Hospital-Onset ICU Bloodstream Infections at an Academic Medical Center. Chest 2017 May;151(5):1011-1017

Date

02/22/2017

Pubmed ID

28215789

DOI

10.1016/j.chest.2017.02.008

Scopus ID

2-s2.0-85019108904 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

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.

Author List

Civitarese AM, Ruggieri E, Walz JM, Mack DA, Heard SO, Mitchell M, Lilly CM, Landry KE, Ellison RT 3rd

Author

Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

APACHE
Academic Medical Centers
Bacteremia
Blood Culture
Candidemia
Gastrointestinal Diseases
Gram-Negative Bacterial Infections
Gram-Positive Bacterial Infections
Humans
Intensive Care Units
Linear Models
Logistic Models
Mortality
Pseudomonas Infections
Respiratory Tract Infections
Retrospective Studies
Soft Tissue Infections
Staphylococcal Infections
Surgical Wound Infection
United States
Urinary Tract Infections