The burden of mucosal barrier injury laboratory-confirmed bloodstream infection among hematology, oncology, and stem cell transplant patients

To evaluate the impact and burden of the new National Healthcare Safety Network surveillance definition, mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI), in hematology, oncology, and stem cell transplant populations. Retrospective cohort study. Two hematology, oncology,...

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Veröffentlicht in:Infection control and hospital epidemiology 2015-02, Vol.36 (2), p.119-124
Hauptverfasser: Metzger, Kristen E, Rucker, Yvonne, Callaghan, Mary, Churchill, Michelle, Jovanovic, Borko D, Zembower, Teresa R, Bolon, Maureen K
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container_start_page 119
container_title Infection control and hospital epidemiology
container_volume 36
creator Metzger, Kristen E
Rucker, Yvonne
Callaghan, Mary
Churchill, Michelle
Jovanovic, Borko D
Zembower, Teresa R
Bolon, Maureen K
description To evaluate the impact and burden of the new National Healthcare Safety Network surveillance definition, mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI), in hematology, oncology, and stem cell transplant populations. Retrospective cohort study. Two hematology, oncology, and stem cell transplant units at a large academic medical center. Central line-associated bloodstream infections (CLABSIs) identified during a 14-month period were reviewed and classified as MBI-LCBI or non-MBI-LCBI (MBI-LCBI criteria not met). During this period, interventions to improve central line maintenance were implemented. Characteristics of patients with MBI-LCBI and non-MBI-LCBI were compared. Total CLABSI, MBI-LCBI, and non-MBI-LCBI rates were compared between baseline and postintervention phases of the study period. Among 66 total CLABSI cases, 47 (71%) met MBI-LCBI criteria. Patients with MBI-LCBI and non-MBI-LCBI were similar in regard to most clinical and demographic characteristics. Between the baseline and postintervention study periods, the overall CLABSI rate decreased from 3.37 to 3.21 infections per 1,000 line-days (incidence rate ratio, 0.95; 4.7% reduction, P=.84), the MBI-LCBI rate increased from 2.08 to 2.61 infections per 1,000 line-days (incidence rate ratio, 1.25; 25.3% increase, P=.44), and the non-MBI-LCBI rate decreased from 1.29 to 0.60 infections per 1,000 line-days (incidence rate ratio, 0.47; 53.3% reduction, P=.12). Most CLABSIs identified among hematology, oncology, and stem cell transplant patients met MBI-LCBI criteria, and CLABSI prevention efforts did not reduce these infections. Further review of the MBI-LCBI definition and impact is necessary to direct future definition changes and reporting mandates.
doi_str_mv 10.1017/ice.2014.38
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Retrospective cohort study. Two hematology, oncology, and stem cell transplant units at a large academic medical center. Central line-associated bloodstream infections (CLABSIs) identified during a 14-month period were reviewed and classified as MBI-LCBI or non-MBI-LCBI (MBI-LCBI criteria not met). During this period, interventions to improve central line maintenance were implemented. Characteristics of patients with MBI-LCBI and non-MBI-LCBI were compared. Total CLABSI, MBI-LCBI, and non-MBI-LCBI rates were compared between baseline and postintervention phases of the study period. Among 66 total CLABSI cases, 47 (71%) met MBI-LCBI criteria. Patients with MBI-LCBI and non-MBI-LCBI were similar in regard to most clinical and demographic characteristics. Between the baseline and postintervention study periods, the overall CLABSI rate decreased from 3.37 to 3.21 infections per 1,000 line-days (incidence rate ratio, 0.95; 4.7% reduction, P=.84), the MBI-LCBI rate increased from 2.08 to 2.61 infections per 1,000 line-days (incidence rate ratio, 1.25; 25.3% increase, P=.44), and the non-MBI-LCBI rate decreased from 1.29 to 0.60 infections per 1,000 line-days (incidence rate ratio, 0.47; 53.3% reduction, P=.12). Most CLABSIs identified among hematology, oncology, and stem cell transplant patients met MBI-LCBI criteria, and CLABSI prevention efforts did not reduce these infections. 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Retrospective cohort study. Two hematology, oncology, and stem cell transplant units at a large academic medical center. Central line-associated bloodstream infections (CLABSIs) identified during a 14-month period were reviewed and classified as MBI-LCBI or non-MBI-LCBI (MBI-LCBI criteria not met). During this period, interventions to improve central line maintenance were implemented. Characteristics of patients with MBI-LCBI and non-MBI-LCBI were compared. Total CLABSI, MBI-LCBI, and non-MBI-LCBI rates were compared between baseline and postintervention phases of the study period. Among 66 total CLABSI cases, 47 (71%) met MBI-LCBI criteria. Patients with MBI-LCBI and non-MBI-LCBI were similar in regard to most clinical and demographic characteristics. Between the baseline and postintervention study periods, the overall CLABSI rate decreased from 3.37 to 3.21 infections per 1,000 line-days (incidence rate ratio, 0.95; 4.7% reduction, P=.84), the MBI-LCBI rate increased from 2.08 to 2.61 infections per 1,000 line-days (incidence rate ratio, 1.25; 25.3% increase, P=.44), and the non-MBI-LCBI rate decreased from 1.29 to 0.60 infections per 1,000 line-days (incidence rate ratio, 0.47; 53.3% reduction, P=.12). Most CLABSIs identified among hematology, oncology, and stem cell transplant patients met MBI-LCBI criteria, and CLABSI prevention efforts did not reduce these infections. Further review of the MBI-LCBI definition and impact is necessary to direct future definition changes and reporting mandates.</abstract><cop>United States</cop><pub>Cambridge University Press</pub><pmid>25632993</pmid><doi>10.1017/ice.2014.38</doi><tpages>6</tpages></addata></record>
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subjects Adult
Aged
Bacteremia - classification
Bacteremia - microbiology
Bacteremia - prevention & control
Catheter-Related Infections - classification
Catheter-Related Infections - microbiology
Catheter-Related Infections - prevention & control
Central Venous Catheters - adverse effects
Chemotherapy
Cross Infection - classification
Cross Infection - microbiology
Cross Infection - prevention & control
Disease prevention
E coli
Female
Fungemia - classification
Fungemia - microbiology
Fungemia - prevention & control
Graft versus host disease
Hematologic Diseases - therapy
Hematology
Hematopoietic Stem Cell Transplantation
Humans
Infection Control
Infections
Intensive care
Length of stay
Male
Medical laboratories
Middle Aged
Mucous Membrane - injuries
Neoplasms - therapy
Neutropenia
Neutropenia - microbiology
Nursing
Oncology
Patient safety
Retrospective Studies
Stem cell transplantation
Stem cells
Surveillance
Young Adult
title The burden of mucosal barrier injury laboratory-confirmed bloodstream infection among hematology, oncology, and stem cell transplant patients
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