SURVEILLANCE FOR CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSIs): ACCURACY OF DIFFERENT SAMPLING STRATEGIES
E. Kourkouni , G. Baroutis , E. Chorianopoulou , E. Fanaraki , D. Gkentzi , V. Giapros , I. Grivea , K. Kaisari , A. Kapetanaki , S. Karagianni , G. Kourlaba, M. Lithoxopoulou , S. Maistreli , A. Nika , V. Papaevangelou , S. Polychronopoulou , C. Thomou , E. Zaoutis
36th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2018)
Malmö, Sweeden, May 28- June 2, 2018
BACKGROUND: Active daily surveillance of central line days (CLDs) in the assessment of CLABSI rates is time consuming and burdensome for healthcare workers. Sampling of denominator data is a method that could reduce the time necessary to conduct active surveillance. Our objective was to evaluate the accuracy of CLD estimates using various sampling strategies in neonatal and pediatric departments in Greece and to assess the impact on CLABSI rates.
METHODS: TDaily denominator data were collected in 22 units (4 PICUs, 12 NICUS and 6 ONCs) across Greece for 6 consecutive months. 32 sampling strategies were evaluated using the original data as following: 1 fixed day/week, 2 fixed days/week and 1 fixed week/month. CLDs for each month were estimated as follows: (number of CLDs in the sample/number of sampled days/month)*30. The estimated CLDs were used to calculate CLABSI rates. The accuracy of the estimated CLABSI rates was assessed by calculating the percentage error [(observed CLABSI rates-estimated CLABSI rates)/observed CLABSI rates].
RESULTS: The sampling over 2 fixed days/ week seems to provide the most accurate estimates of the monthly CLABSI rates for all the different types of units compared to other strategies (1 fixed day/week, and 1 fixed week/month). The percentage error was found to be ≤5% in ≥85% of months in which sampling was conducted, for several day-pair samples as presented in Table 1. Moreover, results showed that lower number of CLD per month (cut-off 75 days) lead to more accurate estimate of CLABSI rates.
CONCLUSIONS: Sampling over 2 fixed days per week seems to provide a valid alternative to daily collection of CLABSI denominator data. These findings and similar strategies should be evaluated for the surveillance of other healthcare-associated infections.