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Open Access Short report

Variations in catheter-related bloodstream infections rates based on local practices

Soraya Cherifi1*, Georges Mascart2, Anne Dediste3, Marie Hallin49, Michèle Gerard5, Marie-Laurence Lambert6 and Baudouin Byl78

Author Affiliations

1 Infection Control Unit, Brugmann University Hospital, Place A. Van Gehuchten, 4, Brussels, 1020, Belgium

2 Microbiology Department, Brugmann Hospital, Brussels, Belgium

3 Microbiology Department, Saint Pierre Hospital, Brussels, Belgium

4 Microbiology Department, Erasme University Hospital, Brussels, Belgium

5 Infection Control Unit, Saint Pierre Hospital, Brussels, Belgium

6 Healthcare-associated infections unit, Public Health and Surveillance department, Scientific Institute of Public Health, Brussels, Belgium

7 Infection Control Unit, Erasme University Hospital, Brussels, Belgium

8 School of Public Health, Université Libre de Bruxelles, Brussels, Belgium

9 Present address: Centre de Diagnostic Moléculaire, Iris-Lab, Brussels, Belgium

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Antimicrobial Resistance and Infection Control 2013, 2:10  doi:10.1186/2047-2994-2-10

Published: 3 April 2013

Abstract

Background

Catheter-related bloodstream infection (CRBSI) surveillance serves as a quality improvement measure that is often used to assess performance. We reviewed the total number of microbiological samples collected in three Belgian intensive care units (ICU) in 2009–2010, and we described variations in CRBSI rates based on two factors: microbiological documentation rate and CRBSI definition which includes clinical criterion for coagulase-negative Staphylococcus (CNS) episode.

Findings

CRBSI rates were 2.95, 1.13 and 1.26 per 1,000 estimated catheter-days in ICUs A, B and C, respectively. ICU B cultured fewer microbiological samples and reported the lowest CRBSI rate. ICU C had the highest documentation rate but was assisted by support available from the laboratory for processing single CNS positive blood cultures. With the exclusion of clinical criterion, CRBSI rates would be reduced by 19%, 45% and 0% in ICUs A, B and C, respectively.

Conclusion

CRBSI rates may be biased by differences of blood culture sampling and CRBSI definition. These observations suggest that comparisons of CRBSI rates in different ICUs remain difficult to interpret without knowledge of local practices.

Keywords:
Catheter-related bloodstream infection; Surveillance; Intensive care unit