Catheter-Related Bloodstream Infection Surveillance Varies

Differs greatly among PICUs, with more aggressive practices tied to higher CA-BSI rates
By Beth Gilbert
HealthDay Reporter

TUESDAY, Sept. 28 (HealthDay News) -- Catheter-related bloodstream infection (CA-BSI) surveillance practices differ substantially among pediatric intensive care units (PICUs), with more aggressive surveillance practices associated with higher CA-BSI rates, according to research published in the October issue of the American Journal of Infection Control.

Matthew F. Niedner, M.D., of the University of Michigan in Ann Arbor, and colleagues conducted a survey of five health care professions at 16 PICUs to evaluate variability in CA-BSI surveillance practices, management, and attitudes/beliefs in PICUs, and assess whether an association exists between surveillance variation and CA-BSI rates. There were 146 respondents.

All 10 infection control respondents reported excluding or including central line types that were inconsistent with the U.S. Centers for Disease Control and Prevention definition for CA-BSI, with five calculating line-days inconsistently and only five using a strict, written policy for classifying BSIs. While more than 80 percent of centers reported having a formal, written policy about obtaining blood cultures, fewer than 80 percent of them obtained samples from patients with central venous lines, and policy adherence was followed less than 50 percent of the time. The investigators also found a significant association between CA-BSI rates and a surveillance aggressiveness score, which was developed to quantify practices likely to increase identification of BSIs.

"These data show substantial variability within and between PICUs in regard to BSI surveillance practices that appear to influence an institution's CA-BSI rate," the authors write.

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