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 |
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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 |
format | Article |
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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.</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1017/ice.2014.38</identifier><identifier>PMID: 25632993</identifier><language>eng</language><publisher>United States: Cambridge University Press</publisher><subject>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</subject><ispartof>Infection control and hospital epidemiology, 2015-02, Vol.36 (2), p.119-124</ispartof><rights>2014 by The Society for Healthcare Epidemiology of America. All rights reserved</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-642c115f5c100e4e931ae784374a27147b4e5cefa6b5b4b88786d697603421f43</citedby><cites>FETCH-LOGICAL-c317t-642c115f5c100e4e931ae784374a27147b4e5cefa6b5b4b88786d697603421f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2808398228/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2808398228?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,43781,74045</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25632993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Metzger, Kristen E</creatorcontrib><creatorcontrib>Rucker, Yvonne</creatorcontrib><creatorcontrib>Callaghan, Mary</creatorcontrib><creatorcontrib>Churchill, Michelle</creatorcontrib><creatorcontrib>Jovanovic, Borko D</creatorcontrib><creatorcontrib>Zembower, Teresa R</creatorcontrib><creatorcontrib>Bolon, Maureen K</creatorcontrib><title>The burden of mucosal barrier injury laboratory-confirmed bloodstream infection among hematology, oncology, and stem cell transplant patients</title><title>Infection control and hospital epidemiology</title><addtitle>Infect Control Hosp Epidemiol</addtitle><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.</description><subject>Adult</subject><subject>Aged</subject><subject>Bacteremia - classification</subject><subject>Bacteremia - microbiology</subject><subject>Bacteremia - prevention & control</subject><subject>Catheter-Related Infections - classification</subject><subject>Catheter-Related Infections - microbiology</subject><subject>Catheter-Related Infections - prevention & control</subject><subject>Central Venous Catheters - adverse effects</subject><subject>Chemotherapy</subject><subject>Cross Infection - classification</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - prevention & control</subject><subject>Disease prevention</subject><subject>E coli</subject><subject>Female</subject><subject>Fungemia - classification</subject><subject>Fungemia - microbiology</subject><subject>Fungemia - prevention & control</subject><subject>Graft versus host disease</subject><subject>Hematologic Diseases - therapy</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Infection Control</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Length of stay</subject><subject>Male</subject><subject>Medical laboratories</subject><subject>Middle Aged</subject><subject>Mucous Membrane - injuries</subject><subject>Neoplasms - therapy</subject><subject>Neutropenia</subject><subject>Neutropenia - microbiology</subject><subject>Nursing</subject><subject>Oncology</subject><subject>Patient safety</subject><subject>Retrospective Studies</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Surveillance</subject><subject>Young Adult</subject><issn>0899-823X</issn><issn>1559-6834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpd0btqHDEUBmARYuL1pXJvBG4Mzmx0HUmlMbmBIY0D6YSkOWPPMiOtJU2xD-F39ixeu0h1TvHxczg_QheUrCmh6tsQYM0IFWuuP6EVldI0rebiM1oRbUyjGf93jE5K2RBClDH0CzpmsuXMGL5CLw9PgP2cO4g49XiaQypuxN7lPEDGQ9zMeYdH51N2NeVdE1LshzxBh_2YUldqBjctrodQhxSxm1J8xE8wLXxMj7uvOMVw2FzscKkw4QDjiGt2sWxHFyveujpArOUMHfVuLHB-mKfo74_vD3e_mvs_P3_f3d43gVNVm1awQKnsZaCEgADDqQOlBVfCMUWF8gJkgN61XnrhtVa67VqjWsIFo73gp-j6LXeb0_MMpdppKPujXIQ0F0tbyYTgkpuFXv1HN2nOcbnOMk00N5oxvaibNxVyKiVDb7d5mFzeWUrsviW7tGT3LVm-15eHzNkvn_yw77XwV0KWj1g</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Metzger, Kristen E</creator><creator>Rucker, Yvonne</creator><creator>Callaghan, Mary</creator><creator>Churchill, Michelle</creator><creator>Jovanovic, Borko D</creator><creator>Zembower, Teresa R</creator><creator>Bolon, Maureen K</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>The burden of mucosal barrier injury laboratory-confirmed bloodstream infection among hematology, oncology, and stem cell transplant patients</title><author>Metzger, Kristen E ; Rucker, Yvonne ; Callaghan, Mary ; Churchill, Michelle ; Jovanovic, Borko D ; Zembower, Teresa R ; Bolon, Maureen K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c317t-642c115f5c100e4e931ae784374a27147b4e5cefa6b5b4b88786d697603421f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bacteremia - classification</topic><topic>Bacteremia - microbiology</topic><topic>Bacteremia - prevention & control</topic><topic>Catheter-Related Infections - classification</topic><topic>Catheter-Related Infections - microbiology</topic><topic>Catheter-Related Infections - prevention & control</topic><topic>Central Venous Catheters - adverse effects</topic><topic>Chemotherapy</topic><topic>Cross Infection - classification</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - prevention & control</topic><topic>Disease prevention</topic><topic>E coli</topic><topic>Female</topic><topic>Fungemia - classification</topic><topic>Fungemia - microbiology</topic><topic>Fungemia - prevention & control</topic><topic>Graft versus host disease</topic><topic>Hematologic Diseases - therapy</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Infection Control</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Length of stay</topic><topic>Male</topic><topic>Medical laboratories</topic><topic>Middle Aged</topic><topic>Mucous Membrane - injuries</topic><topic>Neoplasms - therapy</topic><topic>Neutropenia</topic><topic>Neutropenia - microbiology</topic><topic>Nursing</topic><topic>Oncology</topic><topic>Patient safety</topic><topic>Retrospective Studies</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Surveillance</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Metzger, Kristen E</creatorcontrib><creatorcontrib>Rucker, Yvonne</creatorcontrib><creatorcontrib>Callaghan, Mary</creatorcontrib><creatorcontrib>Churchill, Michelle</creatorcontrib><creatorcontrib>Jovanovic, Borko D</creatorcontrib><creatorcontrib>Zembower, Teresa R</creatorcontrib><creatorcontrib>Bolon, Maureen K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Metzger, Kristen E</au><au>Rucker, Yvonne</au><au>Callaghan, Mary</au><au>Churchill, Michelle</au><au>Jovanovic, Borko D</au><au>Zembower, Teresa R</au><au>Bolon, Maureen K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The burden of mucosal barrier injury laboratory-confirmed bloodstream infection among hematology, oncology, and stem cell transplant patients</atitle><jtitle>Infection control and hospital epidemiology</jtitle><addtitle>Infect Control Hosp Epidemiol</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>36</volume><issue>2</issue><spage>119</spage><epage>124</epage><pages>119-124</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>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.</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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