title: Development of a modified surveillance definition of central line-associated bloodstream infections for patients with hematologic malignancies.
abstract: OBJECTIVE
  To develop a modified surveillance definition of central line-associated bloodstream infection (mCLABSI) specific for our population of patients with hematologic malignancies to better support ongoing improvement efforts at our hospital.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Hematologic malignancies population in a 1,200-bed tertiary care hospital on a 22-bed bone marrow transplant (BMT) unit and a 22-bed leukemia unit.
  
  
  METHODS
  An mCLABSI definition was developed, and pathogens and rates were compared against those determined using the National Healthcare Safety Network (NHSN) definition.
  
  
  RESULTS
  By the NHSN definition the CLABSI rate on the BMT unit was 6.0 per 1,000 central line-days, and by the mCLABSI definition the rate was 2.0 per 1,000 line-days ([Formula: see text]). On the leukemia unit, the NHSN CLABSI rate was 14.4 per 1,000 line-days, and the mCLABSI rate was 8.2 per 1,000 line-days ([Formula: see text]). The top 3 CLABSI pathogens by the NHSN definition were Enterococcus species, Klebsiella species, and Escherichia coli. The top 3 CLABSI pathogens by the mCLABSI definition were coagulase-negative Staphylococcus (CONS), Pseudomonas aeruginosa, and Staphylococcus aureus. The difference in the incidence of CONS as a cause of CLABSI under the 2 definitions was statistically significant ([Formula: see text]).
  
  
  CONCLUSIONS
  A modified surveillance definition of CLABSI was associated with an increase in the identification of staphylococci as the cause of CLABSIs, as opposed to enteric pathogens, and a decrease in CLABSI rates.
authors.affiliation: Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland, Ohio, USA. digiorm@ccf.org
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Digiorgio
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fatica
authors.forename: Mary
authors.initials: M
authors.lastname: Oden
authors.forename: Brian
authors.initials: B
authors.lastname: Bolwell
authors.forename: Mikkael
authors.initials: M
authors.lastname: Sekeres
authors.forename: Matt
authors.initials: M
authors.lastname: Kalaycio
authors.forename: Patti
authors.initials: P
authors.lastname: Akins
authors.forename: Christina
authors.initials: C
authors.lastname: Shane
authors.forename: Jacob
authors.initials: J
authors.lastname: Bako
authors.forename: Steven M
authors.initials: SM
authors.lastname: Gordon
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Fraser
mesh_terms: D055499:Catheter-Related Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015331:Cohort Studies; D003428:Cross Infection / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D003937:Diagnosis, Differential; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology