Infection Control & Hospital Epidemiology


Table 1. Healthcare-Associated Bloodstream Infection Cases, Patient Days, and Pooled Incidence Rates for Each BACTOT Surveillance Year Surveillance year


1


Hospitals Cases


Patient days Pooled


incidence rate (95% CI)


77 2,169 (4.98–5.41) Note. CI, confidence interval. 2 77 2,248 5.34 (5.12–5.57) 3 77 2,038 4.90 (4.69–5.12) 4 67 1,942 5.37 (5.14–5.61) 5 56 1,788 5.49 (5.24–5.75) 6 53 1,563 5.23 (4.98–5.5) 7 51 1,479 5.35 (5.08–5.63) 8 51 1,356 4.95 (4.69–5.22) 9 46 1,323 5.28 (5.00–5.57)


309


10 40


Overall 77


1,275 17,181


4,176,598 4,207,114 4,159,564 3,618,735 3,258,880 2,986,131 2,762,369 2,738,324 2,506,465 2,278,894 33,029,870 5.19


5.59 (5.29–5.91) 5.20 (5.12–5.28)


Fig. 1. Summary of the posterior distribution of the contribution of the hospital effects to the healthcare-associated bloodstream infection rate, stratified by calendar year of entry into BACTOT. Solid circles are the posterior mean for a single hospital and solid lines represent the limits of the 95% posterior credible intervals.


40 hospitals (51%) participated for the full 10 years, contributing 76% of total cases and 71% of total patient days. Of the included hospitals, 20 (26%) were teaching hospitals, contributing 46% of total patient days. Only 1 teaching hospital did not have an ICU. Among nonteaching hospitals, 34 (60%) had ICUs. The median number of beds per hospital was 153 (IQR, 54-283). Among hospitals with ICUs, the median number of ICU beds was 10 (IQR, 8-16).


Cases and rates


Overall, 17,479 cases and 33,029,870 patient days were recorded for the cohort. The proportions of the HABSI subtypes were deter- mined: CA-BSI (21%), NCA-BSI (20%), BSI-UTI (22%), BSI- PULM (11%), BSI-SSI (12%), BSI-ABDO (8%), BSI-SST (3%), BSI-BONE (1%), and BSI-Other (3%). The raw pooled cohort HABSI rate for the 10-year period was 5.20 per 10,000 patient days (95% CI, 5.12–5.28). No clear trend in the raw pooled annual


cohort HABSI rates was observed (Table 1). The large variation in HABSI rates across hospitals was captured by the hospital com- ponent, independent of year and period (Fig. 1). For example, the hospital component of 2 teaching hospitals that entered in 2007– 2008 accounted for >7.5 per 10,000 patient days of their overall HABSI rate, whereas all nonteaching hospitals without ICUs enter- ing the same year accounted for <2.5 per 10,000 patient days. Teaching hospitals tended to have the highest rates, followed by nonteaching hospitals with ICUs (Table 2). An additional 10 beds in a hospital was associated with slightly higher rates of HABSI and the analyzed subtypes. In most instances, year of entry had no clear influence on these rates (Table 3).


Surveillance effect


HABSI incidence rates across surveillance years did not change substantially (Supplementary Figure 1 online). For HABSI, CA- BSI, and BSI-UTI, there was no difference between the estimated


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132