title: Central line-associated bloodstream infection surveillance outside the intensive care unit: a multicenter survey.
abstract: OBJECTIVE
  The success of central line-associated bloodstream infection (CLABSI) prevention programs in intensive care units (ICUs) has led to the expansion of surveillance at many hospitals. We sought to compare non-ICU CLABSI (nCLABSI) rates with national reports and describe methods of surveillance at several participating US institutions.
  
  
  METHODS
  An electronic survey of several medical centers about infection surveillance practices and rate data for non-ICU patients.
  
  
  METHODS
  Ten tertiary care hospitals.
  
  
  METHODS
  In March 2011, a survey was sent to 10 medical centers. The survey consisted of 12 questions regarding demographics and CLABSI surveillance methodology for non-ICU patients at each center. Participants were also asked to provide available rate and device utilization data.
  
  
  RESULTS
  Hospitals ranged in size from 238 to 1,400 total beds (median, 815). All hospitals reported using Centers for Disease Control and Prevention (CDC) definitions. Denominators were collected by different means: counting patients with central lines every day (5 hospitals), indirectly estimating on the basis of electronic orders ([Formula: see text]), or another automated method ([Formula: see text]). Rates of nCLABSI ranged from 0.2 to 4.2 infections per 1,000 catheter-days (median, 2.5). The national rate reported by the CDC using 2009 data from the National Healthcare Surveillance Network was 1.14 infections per 1,000 catheter-days.
  
  
  CONCLUSIONS
  Only 2 hospitals were below the pooled CLABSI rate for inpatient wards; all others exceeded this rate. Possible explanations include differences in average central line utilization or hospital size in the impact of certain clinical risk factors notably absent from the definition and in interpretation and reporting practices. Further investigation is necessary to determine whether the national benchmarks are low or whether the hospitals surveyed here represent a selection of outliers.
authors.affiliation: Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. sonc@mskcc.org
authors.forename: Crystal H
authors.initials: CH
authors.lastname: Son
authors.forename: Titus L
authors.initials: TL
authors.lastname: Daniels
authors.forename: Janet A
authors.initials: JA
authors.lastname: Eagan
authors.forename: Michael B
authors.initials: MB
authors.lastname: Edmond
authors.forename: Neil O
authors.initials: NO
authors.lastname: Fishman
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Fraser
authors.forename: Mini
authors.initials: M
authors.lastname: Kamboj
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Maragakis
authors.forename: Sapna A
authors.initials: SA
authors.lastname: Mehta
authors.forename: Trish M
authors.initials: TM
authors.lastname: Perl
authors.forename: Michael S
authors.initials: MS
authors.lastname: Phillips
authors.forename: Connie S
authors.initials: CS
authors.lastname: Price
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Talbot
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wilson
authors.forename: Kent A
authors.initials: KA
authors.lastname: Sepkowitz
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D019538:Health Care Surveys; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014481:United States