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

Kristen E. Metzger*, Yvonne Rucker, Mary Callaghan, Michelle Churchill, Borko Jovanovic, Teresa R Zembower, Maureen K Bolon

*Corresponding author for this work

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Objective. 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. design. Retrospective cohort study. setting. Two hematology, oncology, and stem cell transplant units at a large academic medical center. methods. Centralline-associated blood stream 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. results. Among66totalCLABSIcases,47(71%) metMBI-LCBIcriteria. Patients withMBI-LCBIandnon-MBI-LCBI weresimilarin 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). conclusions. 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.

Original languageEnglish (US)
Pages (from-to)119-124
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume36
Issue number2
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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