Incidence Trends in Hospital-Onset Bloodstream Infections in Grady Memorial Hospital, 2014-2017 Open Access

Mongillo, Joshua (Spring 2019)

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The overall purpose of this study was to analyze incidence trends in hospital-onset bloodstream infections in Grady Memorial Hospital from 2014 to 2017. Limited data regarding all BSIs occurring during hospital stay were prospectively recorded and reviewed by the infection preventionist team and reviewed to identify BSIs from 1/1/2014 to 12/31/2017. The hypothesis was that from 2014-2017, there was an increase in primary bloodstream infections and an unchanging rate of central line associated bloodstream infections and secondary bloodstream infections in Grady Memorial Hospital facility wide; and that the increase in primary bloodstream infection is attributed to an increase in Staphylococcus aureus related infections and confined to intensive care unit rooms compared to Wards. Using a poisson regression to examine if quarter significantly influenced bloodstream infections, it was determined that primary bloodstream infections significantly increased, on average, by 7.7% (p<0.001) per quarter in ward locations and 9.1% (p=.03) per quarter in intensive care units. The pathogen distribution for each bloodstream infection type was then examined to determine if there were specific pathogens causing the significant increase in primary bloodstream infections. There were no specific pathogens responsible for the increase in primary bloodstream infections. Possible reasons for the significant increase in primary bloodstream infections is the decrease in the amount of central lines and the increase in primary line usage. Device utilization ratios were calculated (central line days/patient days) for facility wide, intensive care unit, and ward locations. In all these settings, device utilizations were decreasing thus verifying a decrease in central line usage. Overall, bloodstream infections cost hospitals millions of dollars annually. This study showed that primary bloodstream infections at Grady Memorial Hospital significantly increased from 2014-2017 with no specific pathogen responsible for the increase.

Table of Contents

Table of Contents

Introduction. 1

Methods. 5

Results. 8

Discussion. 10

Conclusion. 12

Appendix. 14

References. 25


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