Pathogens causing central-line-associated bloodstream infections in acute-care hospitals-United States, 2011-2017

Infect Control Hosp Epidemiol. 2020 Mar;41(3):313-319. doi: 10.1017/ice.2019.303. Epub 2020 Jan 9.

Abstract

Objective: To describe pathogen distribution and rates for central-line-associated bloodstream infections (CLABSIs) from different acute-care locations during 2011-2017 to inform prevention efforts.

Methods: CLABSI data from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) were analyzed. Percentages and pooled mean incidence density rates were calculated for a variety of pathogens and stratified by acute-care location groups (adult intensive care units [ICUs], pediatric ICUs [PICUs], adult wards, pediatric wards, and oncology wards).

Results: From 2011 to 2017, 136,264 CLABSIs were reported to the NHSN by adult and pediatric acute-care locations; adult ICUs and wards reported the most CLABSIs: 59,461 (44%) and 40,763 (30%), respectively. In 2017, the most common pathogens were Candida spp/yeast in adult ICUs (27%) and Enterobacteriaceae in adult wards, pediatric wards, oncology wards, and PICUs (23%-31%). Most pathogen-specific CLABSI rates decreased over time, excepting Candida spp/yeast in adult ICUs and Enterobacteriaceae in oncology wards, which increased, and Staphylococcus aureus rates in pediatric locations, which did not change.

Conclusions: The pathogens associated with CLABSIs differ across acute-care location groups. Learning how pathogen-targeted prevention efforts could augment current prevention strategies, such as strategies aimed at preventing Candida spp/yeast and Enterobacteriaceae CLABSIs, might further reduce national rates.

MeSH terms

  • Adult
  • Aged
  • Candida / isolation & purification
  • Candidiasis / epidemiology
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology*
  • Catheterization, Central Venous / adverse effects
  • Child
  • Child, Preschool
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / epidemiology
  • Female
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • United States / epidemiology