title: Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013.
abstract: OBJECTIVES To determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line-associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN) DESIGN Descriptive analysis of 2013 NHSN data SETTING Selected inpatient locations in acute care hospitals METHODS A descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type. RESULTS From 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%. CONCLUSIONS An understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest. Infect. Control Hosp. Epidemiol. 2015;37(1):2-7.
authors.affiliation: 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Epstein
authors.affiliation: 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Isaac
authors.initials: I
authors.lastname: See
authors.affiliation: 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.affiliation: 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Shelley S
authors.initials: SS
authors.lastname: Magill
authors.affiliation: 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Thompson
mesh_terms: D018988:Bacterial Translocation; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D055499:Catheter-Related Infections / Q000453:epidemiology*; D062905:Central Venous Catheters / Q000009:adverse effects; D003422:Critical Care / Q000706:statistics & numerical data; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology*; D009503:Neutropenia / Q000453:epidemiology; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology; D014184:Transplantation, Homologous; D014481:United States / Q000453:epidemiology