Tracking a hospitals' central line-associated bloodstream infection rate is an important quality measure, but it is difficult to determine objectively and account for variability. A new study suggests evaluating hospital-onset bacteremia as a healthcare-associated infection-related outcome measure instead.
The study was published in Infection Control & Hospital Epidemiology. The researchers who authored the study argue examining the association between hospital-onset bacteremia, or any positive blood culture obtained 48 hours post admission, and CLABSI rates can be useful.
By comparing the power of hospital-onset bacteremia and CLABSI rates, the researchers were able to discriminate quality among intensive care units at different hospitals using standardized infection ratios with 95 percent confidence intervals.
Using data collected from 80 ICUs from 16 U.S. and Canadian hospitals, the researchers identified a total of 663 CLABSIs, 475,420 central line days, 11,280 hospital-onset bacteremia, and 966,757 patient days. They found an absolute change in hospital-onset bacteremia of one per 1,000 patient days was associated with a 2.5 percent change in CLABSI rate.
Ultimately, the researchers concluded, "Change in [hospital-onset bacteremia] rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances. Consideration should be given to using [hospital-onset bacteremia] to replace CLABSI as an outcome measure in infection prevention quality assessments."
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