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Performance characteristics and associated outcomes for an automated surveillance tool for bloodstream infection.

Abstract：

BACKGROUND:The objective of this study was to evaluate performance metrics and associated patient outcomes of an automated surveillance system, the blood Nosocomial Infection Marker (NIM). METHODS:We reviewed records of 237 patients with and 36,927 patients without blood NIM using the National Healthcare Safety Network (NHSN) definition for laboratory-confirmed bloodstream infection (BSI) as the gold standard. We matched cases with noncases by propensity score and estimated attributable mortality and cost of NHSN-reportable central line-associated bloodstream infections (CLABSIs) and non-NHSN-reportable BSIs. RESULTS:For patients with central lines (CL), the blood NIM had 73.2% positive predictive value (PPV), 99.9% negative predictive value (NPV), 89.2% sensitivity, and 99.7% specificity. For all patients regardless of CL status, the blood NIM had 53.6% PPV, 99.9% NPV, 84.0% sensitivity, and 99.9% specificity. For CLABSI cases compared with noncases, mortality was 17.5% versus 9.4% (P = .098), and median charge was $143,935 (interquartile range [IQR], $89,794-$257,447) versus $115,267 (IQR, $74,937-$173,053) (P < .01). For non-NHSN-reportable BSI cases compared with noncases, mortality was 23.6% versus 6.7% (P < .0001), and median charge was $86,927 (IQR, $54,728-$156,669) versus $62,929 (IQR, $36,743-$115,693) (P < .0001). CONCLUSIONS:The NIM is an effective screening tool for BSI. Both NHSN-reportable and nonreportable BSI cases were associated with increased mortality and cost.

journal_name

Am J Infect Control

journal_title

American journal of infection control

authors

Ridgway JP,Sun X,Tabak YP,Johannes RS,Robicsek A

doi

10.1016/j.ajic.2015.12.044

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

567-71

issue

5

eissn

0196-6553

issn

1527-3296

pii

S0196-6553(16)00042-0

journal_volume

44

pub_type

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