Evaluation of hospital-onset bloodstream infections compared to central line...associated bloodstream infections at an acute, tertiary care hospital

Abstract

CLABSI is the current benchmark used in HAI surveillance and effective interventions have greatly reduced the incidence in recent years. However, BSIs continue to be a major source of morbidity and mortality in hospitals. HOBSI, which includes central and peripheral line surveillance, may be a more sensitive indicator of preventable BSI. Our objective is to assess the impact of a change to HOBSI surveillance by comparing the incidence of BSIs using the NHSN LabID and BSI definitions compared to CLABSI. Utilizing electronic medical charts, we determined if each blood culture met the HOBSI criteria according to the NHSN LabID and BSI definitions. We calculated the incidence rates per 10,000 patient-days for both definitions and compared them to the CLABSI rate per 10,000 patient-days for the same period. The incidence rate (IR) of HOBSI using the LabID definition was 10.25. Using the BSI definition, we found an IR of 3.77. The IR of CLABSI for the same period was 1.84. After excluding secondary BSIs, the HOBSI rate is still double that of the CLABSI rate. HOBSI surveillance is a more sensitive indicator of BSI than CLABSI, and thus a better target for monitoring effectiveness of interventions.