880 infection control & hospital epidemiology july 2018, vol. 39, no. 7


single-center study, and our findings may not be generalizable to other institutions. The exclusion of candiduria may have had a larger impact on CAUTI rates in our tertiary-care center, with higher rates of candiduria compared to smaller hospitals. We have yet to assess the impact of NHSN definition changes on antimicrobial usage at our institution. Our experience highlights our CLABSI prevention efforts,


definition change has likely led to a more appropriate attribution of catheter-related candidemia by excluding CAUTI as a potential source. Our study has some limitations. This is a retrospective


which led to a decline in CLABSI rates, including the incidence of catheter-related candidemia. In addition, our study also shows that the 2015 NHSN definition change has led to more appropriate CLABSI attribution of catheter-related candide- mia with removal of CAUTI as a potential secondary source. These definition changes have important implications for the perceived effectiveness of CLABSI and CAUTI prevention efforts. These findings underscore the importance of updating surveillance definitions to closely correlate with clinical definitions.


acknowledgments


We would like to thank members of the Department of Infection Prevention and Control at UAB Hospital for their support of this study. Financial support: No financial support was provided relevant to this article. Potential conflicts of interest: All authors report no conflicts of interest relevant to this article.


Affiliations: 1. Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; 2. Division of Infectious Diseases, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama; 3. Department of Infection Preven- tion and Control, University of Alabama at Birmingham, Birmingham, Alabama. Address correspondence to Sonali Advani MD, MPH, Associate Hospital Epidemiologist, Yale-New Haven Hospital, Assistant Professor of Medicine, Section of Infectious Diseases, Yale University School of Medicine, 20 York St, HB 527, New Haven, CT 06510 (sonali.advani@yale.edu). PREVIOUS PRESENTATION. The data from this study were presented in


part at the 55th Annual Meeting of the Infectious Diseases Society of America, IDWeek 2017 on October 5, 2017, in San Diego, California, as a poster presentation (abstract 474) in the session “HAI: Surveillance Plus Reporting.”


Received January 4, 2018; accepted March 4, 2018; electronically published


April 18, 2018 © 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2018/3907-0019. DOI: 10.1017/ice.2018.78


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