Incidence of central line infection

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Intravenous literature: Infection Control Today report on a study that indicates that some MRSA infections in ICU patients have been decreasing in recent years. The website states…

“To provide information on the recent trend in the incidence of MRSA central line-associated BSIs in U.S. intensive care units, Deron C. Burton, MD, JD, MPH, of the Centers for Disease Control and Prevention (CDC), and colleagues analyzed national healthcare-associated infection surveillance data reported by hospitals to the CDC. These data, covering the period from 1997-2007, were used to calculate annual central line-associated BSI incidence rates for seven types of adult and pediatric ICUs.

From 1997 through 2007, 1,684 ICUs reported 33,587 central line-associated BSIs, of which 2,498 (7.4 percent) were MRSA and 1,590 (4.7 percent) were methicillin-susceptible Staphylococcus aureus (MSSA). The researchers found that although the overall percentage of S. aureus central line-associated BSIs due to MRSA (called “percent MRSA”) increased 25.8 percent from 1997 through 2007, the overall incidence rate of MRSA central line–associated BSIs declined 49.6 percent from 1997 through 2007.  This overall decline occurred despite an initial increase in infection rate from 1997 through 2001, after which the rate steadily declined through 2007.

From 2001 through 2007, MRSA central line–associated BSI incidence declined significantly in all six adult ICU types and was stable in pediatric ICUs. Changes in MRSA central line–associated BSI incidence ranged from −51.5 percent in medical-surgical ICUs without a major teaching affiliation to −69.2 percent in surgical ICUs. In every ICU type, MSSA central line-associated BSI incidence declined continuously and significantly from 1997 through 2007, with estimated incidence changes ranging from −60.1 percent in surgical ICUs to −77.7 percent in medical ICUs.

The authors suggest that these decreases in incidence may be attributable to efforts by health care facilities to improve adherence to CDC’s evidence-based prevention guidelines, the implementation of strategies designed to improve central line insertion and care practices, and increasing success in preventing MRSA transmission between patients by healthcare facilities”.

Original reference: JAMA. 2009;301[7]:727-736; JAMA. 2009;301[7]:772-773.

Read the full report on ITC here.

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