title: Characterising health care-associated bloodstream infections in public hospitals in Queensland, 2008-2012.
abstract: OBJECTIVE
  To describe the epidemiology and rates of all health care-associated bloodstream infections (HA-BSIs) and of specific HA-BSI subsets in public hospitals in Queensland.
  
  
  METHODS
  Standardised HA-BSI surveillance data were collected in 23 Queensland public hospitals, 2008-2012.
  
  
  METHODS
  HA-BSIs were prospectively classified in terms of place of acquisition (inpatient, non-inpatient); focus of infection (intravascular catheter-associated, organ site focus, neutropenic sepsis, or unknown focus); and causative organisms. Inpatient HA-BSI rates (per 10,000 patient-days) were calculated.
  
  
  RESULTS
  There were 8092 HA-BSIs and 9418 causative organisms reported. Inpatient HA-BSIs accounted for 79% of all cases. The focus of infection in 2792 cases (35%) was an organ site, intravascular catheters in 2755 (34%; including 2240 central line catheters), neutropenic sepsis in 1063 (13%), and unknown in 1482 (18%). Five per cent (117 of 2240) of central line-associated BSIs (CLABSIs) were attributable to intensive care units (ICUs). Eight groups of organisms provided 79% of causative agents: coagulase-negative staphylococci (18%), Staphylococcus aureus (15%), Escherichia coli (11%), Pseudomonas species (9%), Klebsiella pneumoniae/oxytoca (8%), Enterococcus species (7%), Enterobacter species (6%), and Candida species (5%). The overall inpatient HA-BSI rate was 6.0 per 10,000 patient-days. The rates for important BSI subsets included: intravascular catheter-associated BSIs, 1.9 per 10,000 patient-days; S. aureus BSIs, 1.0 per 10,000 patient-days; and methicillin-resistant S. aureus BSIs, 0.3 per 10,000 patient-days.
  
  
  CONCLUSIONS
  The rate of HA-BSIs in Queensland public hospitals is lower than reported by similar studies elsewhere. About one-third of HA-BSIs are attributable to intravascular catheters, predominantly central venous lines, but the vast majority of CLABSIs are contracted outside ICUs. Different sources of HA-BSIs require different prevention strategies.
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, QLD damin.si@health.qld.gov.au.
authors.forename: Damin
authors.initials: D
authors.lastname: Si
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Naomi
authors.initials: N
authors.lastname: Runnegar
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, QLD.
authors.forename: John
authors.initials: J
authors.lastname: Marquess
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, QLD.
authors.forename: Mohana
authors.initials: M
authors.lastname: Rajmokan
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Elliott G
authors.initials: EG
authors.lastname: Playford
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology*; D062665:Epidemiological Monitoring; D006779:Hospitals, Public; D006801:Humans; D007297:Inpatients; D011793:Queensland / Q000453:epidemiology; D062666:Vascular Access Devices / Q000009:adverse effects