Incidence Trends in Pathogen-specific, Central Line-associated Bloodstream Infections in US Intensive Care Units, 1990–2010

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Fagan, Ryan P ; Edwards, Jonathan R ; Park, Benjamin J ; Fridkin, Scott K ; Magill, Shelley S
• Description:
  Objective
  
  To quantify historical trends in rates of central line-associated bloodstream infections (CLABSIs) in U.S. intensive care units (ICUs) caused by major pathogen groups, including Candida spp., Enterococcus spp., specified Gram-negative rods, and Staphylococcus aureus.
  
  Design
  
  Active surveillance in a cohort of participating ICUs through the U.S. Centers for Disease Control and Prevention (CDC), National Nosocomial Infections Surveillance (NNIS) system during 1990–2004 and the National Healthcare Safety Network (NHSN) during 2006–2010.
  
  Setting
  
  ICUs
  
  Patients or participants
  
  Patients who were admitted to participating ICUs
  
  Interventions
  
  None
  
  Results
  
  The CLABSI incidence density rate for S. aureus decreased annually starting in 2002 and remained lower than for other pathogen groups. Since 2006, the annual decrease for S. aureus CLABSIs in non-pediatric ICU types was −18.3% (95% CI, −20.8% to −15.8%), whereas the incidence density rate for S. aureus among pediatric ICUs did not change. The annual decrease for all ICUs combined since 2006 was −17.8% (95% CI, −19.4% to −16.1%) for Enterococcus spp., −16.4% (95% CI, −18.2% to −14.7%) for Gram-negative rods, and −13.5% (95% CI, −15.4% to −11.5%) for Candida spp.
  
  Conclusions
  
  Patterns of ICU CLABSI incidence density rates among major pathogen groups have changed considerably during recent decades. CLABSI incidence declined steeply since 2006, except for CLABSI due to S. aureus in pediatric ICUs. There is a need to better understand CLABSIs that still do occur based on microbiological and patient characteristics. New prevention approaches may be needed in addition to central line insertion and maintenance practices.
  
  
• Subjects:
  Article Candidiasis Catheter-Related Infections Catheterization, Central Venous Cross Infection Enterobacteriaceae Infections Gram-Negative Bacterial Infections Humans Incidence Intensive Care Units Staphylococcal Infections

  More +
• Source:
  Infect Control Hosp Epidemiol. 34(9):893-899
• Pubmed ID:
  23917902
• Pubmed Central ID:
  PMC6452856
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  34
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b3e529504f650400068a313544bd73f1031ab432e60790e70c8e41d5d6c3cf9d
• Download URL:
  https://stacks.cdc.gov/view/cdc/77416/cdc_77416_DS1.pdf
• File Type:
  [PDF - 604.28 KB ]