title: National estimates of central line-associated bloodstream infections in critical care patients.
abstract: OBJECTIVE. Recent studies have demonstrated that central line-associated bloodstream infections (CLABSIs) are preventable through implementation of evidence-based prevention practices. Hospitals have reported CLABSI data to the Centers for Disease Control and Prevention (CDC) since the 1970s, providing an opportunity to characterize the national impact of CLABSIs over time. Our objective was to describe changes in the annual number of CLABSIs in critical care patients in the United States.
  
  
  METHODS
  Monte Carlo simulation. Setting. U.S. acute care hospitals.
  
  
  METHODS
  Nonneonatal critical care patients.
  
  
  METHODS
  We obtained administrative data on patient-days for nearly all US hospitals and applied CLABSI rates from the National Nosocomial Infections Surveillance and the National Healthcare Safety Network systems to estimate the annual number of CLABSIs in critical care patients nationally during the period 1990-2010 and the number of CLABSIs prevented since 1990.
  
  
  RESULTS
  We estimated that there were between 462,000 and 636,000 CLABSIs in nonneonatal critical care patients in the United States during 1990-2010. CLABSI rate reductions led to between 104,000 and 198,000 fewer CLABSIs than would have occurred if rates had remained unchanged since 1990. There were 15,000 hospital-onset CLABSIs in nonneonatal critical care patients in 2010; 70% occurred in medium and large teaching hospitals.
  
  
  CONCLUSIONS
  Substantial progress has been made in reducing the occurrence of CLABSIs in U.S. critical care patients over the past 2 decades. The concentration of critical care CLABSIs in medium and large teaching hospitals suggests that a targeted approach may be warranted to continue achieving reductions in critical care CLABSIs nationally.
authors: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Matthew E
authors: ME
authors: Wise
authors: R Douglas
authors: RD
authors: Scott
authors: James M
authors: JM
authors: Baggs
authors: Jonathan R
authors: JR
authors: Edwards
authors: Katherine D
authors: KD
authors: Ellingson
authors: Scott K
authors: SK
authors: Fridkin
authors: L Clifford
authors: LC
authors: McDonald
authors: John A
authors: JA
authors: Jernigan
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D003422:Critical Care / Q000706:statistics & numerical data*; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D018805:Sepsis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
references: N Engl J Med. 2006 Dec 28;355(26):2725-32
references: 17192537
references: J Clin Epidemiol. 1988;41(11):1125-34
references: 3256304
references: J Hosp Infect. 2009 Feb;71(2):117-22
references: 19013680
references: Milbank Q. 2012 Sep;90(3):548-91
references: 22985281
references: Infect Control Hosp Epidemiol. 2011 Apr;32(4):315-22
references: 21460482
references: Am J Infect Control. 2008 Nov;36(9):609-26
references: 18992647
references: J Antimicrob Chemother. 2008 Oct;62(4):809-15
references: 18621987
references: MMWR Morb Mortal Wkly Rep. 2011 Mar 4;60(8):243-8
references: 21368740
references: MMWR Morb Mortal Wkly Rep. 2005 Oct 14;54(40):1013-6
references: 16224448
references: Infect Control Hosp Epidemiol. 2011 Aug;32(8):748-56
references: 21768757
references: Ann Intensive Care. 2011 Aug 18;1:34
references: 21906266
references: Am J Infect Control. 2004 Dec;32(8):470-85
references: 15573054
references: Infect Control Hosp Epidemiol. 2010 May;31(5):551-3
references: 20334506
references: Crit Care Med. 2003 Jul;31(7):1959-63
references: 12847389
references: Am J Infect Control. 2011 Jun;39(5):349-67
references: 21774120
references: JAMA. 2009 Mar 25;301(12):1231-41
references: 19318651
references: Infect Control Hosp Epidemiol. 2006 Jul;27(7):662-9
references: 16807839
references: Lancet Infect Dis. 2008 Dec;8(12):763-76
references: 19022192