Characterizing Patients Presenting on Hospital Admission with Central Line-Associated Bloodstream Infections : A Multicenter Study
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprintsoup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com..
BACKGROUND: There are no systematic measures of central line-associated bloodstream infections (CLABSIs) in patients maintaining central venous catheters (CVCs) outside acute care hospitals. To improve understanding of the burden of CLABSIs outside acute care hospitals, we characterized patients with CLABSI present on hospital admission (POA).
METHODS: Retrospective cross-sectional analysis of patients with CLABSI-POA in three health systems covering eleven hospitals across Maryland, Washington DC, and Missouri from November 2020 to October 2021. CLABSI-POA was defined using an adaptation of the acute care CLABSI definition. Patient demographics, clinical characteristics, and outcomes were collected via chart review. Cox proportional hazard analysis was used to assess factors associated with all-cause mortality within 30 days.
RESULTS: 461 patients were identified as having CLABSI-POA. CVCs were most commonly maintained in home infusion therapy (32.8%) or oncology clinics (31.2%). Enterobacterales were the most common etiologic agent (29.2%). Recurrent CLABSIs occurred in a quarter of patients (25%). Eleven percent of patients died during the hospital admission. Among CLABSI-POA patients, mortality risk increased with age (versus ages <20: ages 20-44 years: HR: 11.21, 95% CI: 1.46-86.22; ages 45-64: HR: 20.88, 95% CI: 2.84-153.58; at least 65 years of age: HR: 22.50, 95% CI: 2.98-169.93), and lack of insurance (HR: 2.46; 95% CI: 1.08-5.59), and decreased with CVC removal (HR: 0.57, 95% CI: 0.39-0.84).
CONCLUSION: CLABSI-POA is associated with significant in-hospital mortality. Surveillance is required to understand the burden of CLABSI in the community to identify targets for CLABSI prevention initiatives outside acute care settings.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - (2024) vom: 14. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Oladapo-Shittu, Opeyemi [VerfasserIn] |
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| Links: |
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| Themen: |
Ambulatory |
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| Anmerkungen: |
Date Revised 12.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/cid/ciae144 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369736311 |
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| 245 | 1 | 0 | |a Characterizing Patients Presenting on Hospital Admission with Central Line-Associated Bloodstream Infections |b A Multicenter Study |
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| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprintsoup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. | ||
| 520 | |a BACKGROUND: There are no systematic measures of central line-associated bloodstream infections (CLABSIs) in patients maintaining central venous catheters (CVCs) outside acute care hospitals. To improve understanding of the burden of CLABSIs outside acute care hospitals, we characterized patients with CLABSI present on hospital admission (POA) | ||
| 520 | |a METHODS: Retrospective cross-sectional analysis of patients with CLABSI-POA in three health systems covering eleven hospitals across Maryland, Washington DC, and Missouri from November 2020 to October 2021. CLABSI-POA was defined using an adaptation of the acute care CLABSI definition. Patient demographics, clinical characteristics, and outcomes were collected via chart review. Cox proportional hazard analysis was used to assess factors associated with all-cause mortality within 30 days | ||
| 520 | |a RESULTS: 461 patients were identified as having CLABSI-POA. CVCs were most commonly maintained in home infusion therapy (32.8%) or oncology clinics (31.2%). Enterobacterales were the most common etiologic agent (29.2%). Recurrent CLABSIs occurred in a quarter of patients (25%). Eleven percent of patients died during the hospital admission. Among CLABSI-POA patients, mortality risk increased with age (versus ages <20: ages 20-44 years: HR: 11.21, 95% CI: 1.46-86.22; ages 45-64: HR: 20.88, 95% CI: 2.84-153.58; at least 65 years of age: HR: 22.50, 95% CI: 2.98-169.93), and lack of insurance (HR: 2.46; 95% CI: 1.08-5.59), and decreased with CVC removal (HR: 0.57, 95% CI: 0.39-0.84) | ||
| 520 | |a CONCLUSION: CLABSI-POA is associated with significant in-hospital mortality. Surveillance is required to understand the burden of CLABSI in the community to identify targets for CLABSI prevention initiatives outside acute care settings | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a bacteremia | |
| 650 | 4 | |a central venous catheter | |
| 700 | 1 | |a Cosgrove, Sara E |e verfasserin |4 aut | |
| 700 | 1 | |a Rock, Clare |e verfasserin |4 aut | |
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| 700 | 1 | |a Klein, Eili |e verfasserin |4 aut | |
| 700 | 1 | |a Harris, Anthony D |e verfasserin |4 aut | |
| 700 | 1 | |a Mejia Chew, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Saunders, Heather |e verfasserin |4 aut | |
| 700 | 1 | |a Ching, Patrick R |e verfasserin |4 aut | |
| 700 | 1 | |a Gadala, Avi |e verfasserin |4 aut | |
| 700 | 1 | |a Mayoryk, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Pineles, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Maragakis, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Salinas, Alejandra |e verfasserin |4 aut | |
| 700 | 1 | |a Helsel, Taylor |e verfasserin |4 aut | |
| 700 | 1 | |a Keller, Sara C |e verfasserin |4 aut | |
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