The rates of central line–associated bloodstream infections (CLABSIs) in United States intensive care units (ICU) have decreased significantly, and a parallel reduction in the rates of total hospital onset bacteremias in these units should also be expected. We report 10-year trends for total hospital onset ICU-associated bacteremias at a tertiary care academic medical center.
This was a retrospective analysis of all positive blood cultures among patients admitted to seven adult ICUs for the period FY2005 through FY2014 according to Centers for Disease Control and Prevention National Healthcare Safety Network definitions. The rate of change for primary and secondary hospital onset BSIs was determined, as was the distribution of organisms responsible for these BSIs.
Three medical, two general surgical, one combined neurosurgical /trauma, and one cardiac/cardiac surgery adult intensive care units.
Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1000 patient days in FY05 to 0.32/1000 patient days in FY14; an 85.0% decrease (P<0.0001). Secondary BSIs also progressively decreased from 3.56/1000 to 0.66/1000 patient days; an 81.4% decrease (P<0.0001). The decrease of BSI rates remained significant after controlling for the number of blood cultures obtained and patient acuity.
An increased focus on reducing hospital onset infections at the academic medical center during the last 10 years, including multimodal multidisciplinary efforts to prevent central line associated BSIs, pneumonia, Clostridium difficile disease, surgical site infections, and urinary tract infections, was associated with progressive and sustained decreases for both primary and secondary hospital onset BSIs.