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- Title
Characterising health care-associated bloodstream infections in public hospitals in Queensland, 2008–2012.
- Authors
Damin Si; Runnegar, Naomi; Marquess, John; Rajmokan, Mohana; Playford, Elliott G.
- Abstract
Objective: To describe the epidemiology and rates of all health care-associated bloodstream infections (HA-BSIs) and of specific HA-BSI subsets in public hospitals in Queensland. Design and setting: Standardised HA-BSI surveillance data were collected in 23 Queensland public hospitals, 2008e2012. Main outcome measures: HA-BSIs were prospectively classified in terms of place of acquisition (inpatient, non-inpatient); focus of infection (intravascular catheter-associated, organ site focus, neutropenic sepsis, or unknown focus); and causative organisms. Inpatient HA-BSI rates (per 10000 patient-days) were calculated. Results: There were 8092 HA-BSIs and 9418 causative organisms reported. Inpatient HA-BSIs accounted for 79% of all cases. The focus of infection in 2792 cases (35%) was an organ site, intravascular catheters in 2755 (34%; including 2240 central line catheters), neutropenic sepsis in 1063 (13%), and unknown in 1482 (18%). Five per cent (117 of 2240) of central line-associated BSIs (CLABSIs) were attributable to intensive care units (ICUs). Eight groups of organisms provided 79% of causative agents: coagulase-negative staphylococci (18%), Staphylococcus aureus (15%), Escherichia coli (11%), Pseudomonas species (9%), Klebsiella pneumoniae/oxytoca (8%), Enterococcus species (7%), Enterobacter species (6%), and Candida species (5%). The overall inpatient HA-BSI rate was 6.0 per 10000 patient-days. The rates for important BSI subsets included: intravascular catheter-associated BSIs, 1.9 per 10000 patient-days; S. aureus BSIs, 1.0 per 10000 patient-days; and methicillin-resistant S. aureus BSIs, 0.3 per 10000 patient-days. Conclusions: The rate of HA-BSIs in Queensland public hospitals is lower than reported by similar studies elsewhere. About one-third of HA-BSIs are attributable to intravascular catheters, predominantly central venous lines, but the vast majority of CLABSIs are contracted outside ICUs. Different sources of HA-BSIs require different prevention strategies.
- Subjects
INFECTION risk factors; MEDICAL microbiology; ETIOLOGY of diseases; MEDICAL care; PUBLIC health
- Publication
Medical Journal of Australia, 2016, Vol 204, Issue 7, p276.e1
- ISSN
0025-729X
- Publication type
Article
- DOI
10.5694/mja15.00957