Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric

• Type of Material: Article
• Authors: Raymund Dantes, Emory University; Lilian M. Abbo, University of Miami; Deverick Anderson, Duke University; Lisa Hall, University of Queensland; Jennifer H. Han, University of Pennsylvania; Anthony D. Harris, University of Maryland; Surbhi Leekha, University of Maryland; Aaron M. Milstone, Johns Hopkins University; Daniel J. Morgan, University of Maryland; Nasia Safdar, University of Wisconsin; Marin L. Schweizer, Iowa City Veterans Affairs Health Care System; Sharmila Sengupta, Medanta Medicity Hospital; Susan K. Seo, Memorial Sloan Kettering Cancer Center; Clare Rock, Johns Hopkins University
• Language: English
• Date: 2019-05-01
• Publisher: Cambridge University Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 by The Society for Healthcare Epidemiology of America. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/ice.2019.40
• Title of Journal or Parent Work: Infection Control & Hospital Epidemiology
• Volume: 40
• Issue: 5
• Start Page: 536
• End Page: 540
• Grant/Funding Information: A.D.H. is also supported by a grant from the national Institutes of Health (NIH grant no. 5K24AI079040–05).; C.R., A.M.M., A.D.H., and S.L. are supported by the Centers for Disease Control Prevention Epicenters Program.
• Keywords: Infectious Diseases; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Time; Science & Technology
• Research Categories: Health Sciences, Public Health; Health Sciences, Health Care Management; Health Sciences, Epidemiology

Abstract

Objective: To ascertain opinions regarding etiology and preventability of hospital-onset bacteremia and fungemia (HOB) and perspectives on HOB as a potential outcome measure reflecting quality of infection prevention and hospital care. Design: Cross-sectional survey.Participants: Hospital epidemiologists and infection preventionist members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. Methods: A web-based, multiple-choice survey was administered via the SHEA Research Network to 133 hospitals. Results: A total of 89 surveys were completed (67% response rate). Overall, 60% of respondents defined HOB as a positive blood culture on or after hospital day 3. Central line-associated bloodstream infections and intra-abdominal infections were perceived as the most frequent etiologies. Moreover, 61% thought that most HOB events are preventable, and 54% viewed HOB as a measure reflecting a hospital's quality of care. Also, 29% of respondents' hospitals already collect HOB data for internal purposes. Given a choice to publicly report central-line-associated bloodstream infections (CLABSIs) and/or HOB, 57% favored reporting either HOB alone (22%) or in addition to CLABSI (35%) and 34% favored CLABSI alone. Conclusions: Among the majority of SHEA Research Network respondents, HOB is perceived as preventable, reflective of quality of care, and potentially acceptable as a publicly reported quality metric. Further studies on HOB are needed, including validation as a quality measure, assessment of risk adjustment, and formation of evidence-based bundles and toolkits to facilitate measurement and improvement of HOB rates.