Details:

Alternative Title:
Infect Control Hosp Epidemiol
Personal Author:
See, Isaac ; Chang, Julia ; Gualandi, Nicole ; Buser, Genevieve L. ; Rohrbach, Pamela ; ... More +
See, Isaac ; Chang, Julia ; Gualandi, Nicole ; Buser, Genevieve L. ; Rohrbach, Pamela ; Smeltz, Debra A. ; Bellush, Mary Jo ; Coffin, Susan E. ; Gould, Jane M. ; Hess, Debra ; Hennessey, Patricia ; Hubbard, Sydney ; Kiernan, Andrea ; O’Donnell, Judith ; Pegues, David A. ; Miller, Jeffrey R. ; Magill, Shelley S. Less -
Description:
Objective

To determine the clinical diagnoses associated with National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance events.

Design

Retrospective chart review.

Setting

Eight acute care hospitals in Pennsylvania.

Patients

All patients hospitalized during 2011–2012.

Methods

Medical records were reviewed from a random sample of patients reported to NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU/LRI events were recorded.

Results

We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to NHSN; 29 (12%) of reported events fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassification. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia, of which 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or non-infectious) documented at the time of LRI. Of 36 pediatric PNEU events, 72% were ventilator-associated, and 70% corresponded to a clinical pneumonia diagnosis. Of 61 pediatric LRI, 84% were in mechanically-ventilated patients, and 21% had no corresponding clinical diagnosis documented.

Conclusions

In adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded to compatible clinical conditions documented in the medical record. In contrast, NHSN LRI events often did not. As a result, substantial modifications to the LRI definitions were implemented in 2015.


Subject:
[+]
Adult
Aged
Aged, 80 And Over
Child
Child, Preschool
Cross Infection
Humans
Infant
Infant, Newborn
Middle Aged
Pneumonia
Pneumonia, Ventilator-Associated
Population Surveillance
Respiratory Tract Infections
Retrospective Studies

Source:
Infect Control Hosp Epidemiol. 37(7):818-824.
Pubmed ID:
27072043
Pubmed Central ID:
PMC5662932
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Pennsylvania
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:5902ff312468343a674a7202c18848e72ef7cd5ece17a80011df6a49bc7f3fd1
File Type:

Supporting Files

• 	nihms816852.nxml	xml
  	nihms816852f1.gif	gif
  	nihms816852f1.jpg	jpeg

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