Epidemiology and preventability of hospital-onset bacteremia and fungemia in 2 hospitals in India

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Gandra, Sumanth ; Singh, Sanjeev K. ; Chakravarthy, Murali ; Moni, Merlin ; Dhekane, Pruthu ; Mohamed, Zubair ; Shameen, Fathima ; Vasudevan, Anil K. ; Senthil, Priyadarshini ; Saravanan, Tejaswini ; George, Anu ; Sinclair, Dorothy ; Stwalley, Dustin ; van Rheenen, Jacaranda ; Westercamp, Matthew ; Smith, Rachel M. ; Leekha, Surbhi ; Warren, David K.
  More +
• Description:
  Objective: ; Studies evaluating the incidence, source, and preventability of hospital-onset bacteremia and fungemia (HOB), defined as any positive blood culture obtained after 3 calendar days of hospital admission, are lacking in low- and middle-income countries (LMICs). ; Design, setting, and participants: ; All consecutive blood cultures performed for 6 months during 2020-2021 in 2 hospitals in India were reviewed to assess HOB and National Healthcare Safety Network (NHSN) reportable central-line-associated bloodstream infection (CLABSI) events. Medical records of a convenience sample of 300 consecutive HOB events were retrospectively reviewed to determine source and preventability. Univariate and multivariable logistic regression analyses were performed to identify factors associated with HOB preventability. ; Results: ; Among 6,733 blood cultures obtained from 3,558 hospitalized patients, there were 409 and 59 unique HOB and NHSN-reportable CLABSI events, respectively. CLABSIs accounted for 59 (14%) of 409 HOB events. There was a moderate but non-significant correlation (r = 0.51; P = .070) between HOB and CLABSI rates. Among 300 reviewed HOB cases, CLABSIs were identified as source in only 38 (13%). Although 157 (52%) of all 300 HOB cases were potentially preventable, CLABSIs accounted for only 22 (14%) of these 157 preventable HOB events. In multivariable analysis, neutropenia, and sepsis as an indication for blood culture were associated with decreased odds of HOB preventability, whereas hospital stay ≥7 days and presence of a urinary catheter were associated with increased likelihood of preventability. ; Conclusions: ; HOB may have utility as a healthcare-associated infection metric in LMIC settings because it captures preventable bloodstream infections beyond NHSN-reportable CLABSIs.
• Subjects:
  • Bacteremia
  • Catheterization, Central Venous
  • Catheter-Related Infections
  • Cross Infection
  • Fungemia
  • Hospitals
  • Humans
  • Retrospective Studies
  • Sepsis
• Source:
  Infect Control Hosp Epidemiol. 45(2):157-166
• Pubmed ID:
  37593953
• Pubmed Central ID:
  PMC10877540
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; HHSD200201691804I/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  45
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/150275/cdc_150275_DS1.pdf
• File Type:
  [PDF - 722.26 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:02cb3a62586f564cea11897a8dc11b82a28dcf20c3fe802c6da2ba7c09076077aa364c26c8c833abcf648e1b673c95a6ea6cf47b96778d7df2543a4cf6d17cd5