Laboratory-identified vancomycin-resistant enterococci bacteremia incidence: A standardized infection ratio prediction model

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Tanwar, Sukarma S. S. ; Weiner-Lastinger, Lindsey M. ; Bell, Jeneita M. ; Allen-Bridson, Katherine ; Bagchi, Suparna ; Dudeck, Margaret A. ; Edwards, Jonathan R.
• Description:
  Background:
  
  We analyzed 2017 healthcare facility-onset (HO) vancomycin-resistant Enterococcus (VRE) bacteremia data to identify hospital-level factors that were significant predictors of HO-VRE using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) multidrug-resistant organism and Clostridioides difficile reporting module. A risk-adjusted model that can be used to calculate the number of predicted HO-VRE bacteremia events in a facility was developed, thus enabling the calculation of VRE standardized infection ratios (SIRs).
  
  Methods:
  
  Acute-care hospitals reporting at least 1 month of 2017 VRE bacteremia data were included in the analysis. Various hospital-level characteristics were assessed to develop a best-fit model and subsequently derive the 2018 national and state SIRs.
  
  Results:
  
  In 2017, 470 facilities in 35 states participated in VRE bacteremia surveillance. Inpatient VRE community-onset prevalence rate, average length of patient stay, outpatient VRE community-onset prevalence rate, and presence of an oncology unit were all significantly associated (all 95% likelihood ratio confidence limits excluded the nominal value of zero) with HO-VRE bacteremia. The 2018 national SIR was 1.01 (95% CI, 0.93–1.09) with 577 HO bacteremia events reported.
  
  Conclusion:
  
  The creation of an SIR enables national-, state-, and facility-level monitoring of VRE bacteremia while controlling for individual hospital-level factors. Hospitals can compare their VRE burden to a national benchmark to help them determine the effectiveness of infection prevention efforts over time.
  
  
• Subjects:
  Anti-Bacterial Agents Bacteremia Cross Infection Gram-Positive Bacterial Infections Health Facilities Hospitals Humans Vancomycin-Resistant Enterococci
• Source:
  Infect Control Hosp Epidemiol. 43(6):714-718
• Pubmed ID:
  34085620
• Pubmed Central ID:
  PMC8642455
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  43
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bed45ebab1ec36480839aad524af178e0f6b7f01b7c7c56017ca94713f78c125
• Download URL:
  https://stacks.cdc.gov/view/cdc/112342/cdc_112342_DS1.pdf
• File Type:
  [PDF - 76.11 KB ]