Characterising health care-associated bloodstream infections in public hospitals in Queensland, 2008-2012

Si, Damin, Runnegar, Naomi, Marquess, John, Rajmokan, Mohana and Playford, Elliott G. (2016) Characterising health care-associated bloodstream infections in public hospitals in Queensland, 2008-2012. Medical Journal of Australia, 204 7: 276.e1-276.e7. doi:10.5694/mja15.00957

Author Si, Damin
Runnegar, Naomi
Marquess, John
Rajmokan, Mohana
Playford, Elliott G.
Title Characterising health care-associated bloodstream infections in public hospitals in Queensland, 2008-2012
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2016-04-18
Year available 2016
Sub-type Article (original research)
DOI 10.5694/mja15.00957
Open Access Status Not Open Access
Volume 204
Issue 7
Start page 276.e1
End page 276.e7
Total pages 7
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Collection year 2017
Language eng
Formatted abstract
Objective: To describe the epidemiology and rates of all health care-associated bloodstream infections (HA-BSIs) and of specific HA-BSI subsets in public hospitals in Queensland.

Design and setting: Standardised HA-BSI surveillance data were collected in 23 Queensland public hospitals, 2008e2012.

Main outcome measures: HA-BSIs were prospectively classified in terms of place of acquisition (inpatient, non-inpatient); focus of infection (intravascular catheter-associated, organ site focus, neutropenic sepsis, or unknown focus); and causative organisms. Inpatient HA-BSI rates (per 10000 patient-days) were calculated.

Results: There were 8092 HA-BSIs and 9418 causative organisms reported. Inpatient HA-BSIs accounted for 79% of all cases. The focus of infection in 2792 cases (35%) was an organ site, intravascular catheters in 2755 (34%; including 2240 central line catheters), neutropenic sepsis in 1063 (13%), and unknown in 1482 (18%). Five per cent (117 of 2240) of central line-associated BSIs (CLABSIs) were attributable to intensive care units (ICUs). Eight groups of organisms provided 79% of causative agents: coagulase-negative staphylococci (18%), Staphylococcus aureus (15%), Escherichia coli (11%), Pseudomonas species (9%), Klebsiella pneumoniae/ oxytoca (8%), Enterococcus species (7%), Enterobacter species (6%), and Candida species (5%). The overall inpatient HA-BSI rate was 6.0 per 10000 patient-days. The rates for important BSI subsets included: intravascular catheter-associated BSIs, 1.9 per 10000 patient-days; S. aureus BSIs, 1.0 per 10000 patient-days; and methicillin-resistant S. aureus BSIs, 0.3 per 10000 patient-days.

Conclusions: The rate of HA-BSIs in Queensland public hospitals is lower than reported by similar studies elsewhere. About one-third of HA-BSIs are attributable to intravascular catheters, predominantly central venous lines, but the vast majority of CLABSIs are contracted outside ICUs. Different sources of HA-BSIs require different prevention strategies.
Keyword Health care-associated bloodstream infections (HA-BSIs)
Place of acquisition
Focus of infection
Causative organisms
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Sub-type: Article (original research)
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