Sampling for collection of central line-day denominators in surveillance of healthcare-associated bloodstream infections

Infect Control Hosp Epidemiol. 2006 Apr;27(4):338-42. doi: 10.1086/503338. Epub 2006 Mar 28.

Abstract

Objective: To determine the feasibility of estimating the number of central line-days at a hospital from a sample of months or individual days in a year, for surveillance of healthcare-associated bloodstream infections.

Design: We used data reported to the National Nosocomial Infections Surveillance system in the adult and pediatric intensive care unit component for 1995-2003 and data from a sample of hospitals' daily counts of device use for 12 consecutive months. We calculated the percentile error as the central line-associated bloodstream infection percentile based on rates per line-days minus the percentile based on rates per estimated line-days.

Setting and participants: A total of 247 hospitals were used for sampling whole months and 12 hospitals were used for sampling individual days.

Results: For a 1-month sample of central line-days data, the median percentile error was 3.3 (75th percentile, 7.9; 90th percentile, 15.4). The percentile error decreased with an increase in the number of months sampled. For a 3-month sample, the median percentile error was 1.4 (75th percentile, 4.3; 95th percentile, 8.3). Sampling individual days throughout the year yielded lower percentile errors than sampling an equivalent fraction of whole months. With 1 weekday sampled per week, the median percentile error ranged from 0.65 to 1.40, and the 90th percentile ranged from 2.8 to 5.0. Thus, for 90% of units, collecting data on line-days once a week provides an estimate within +/-5 percentile points of the true line-day rate.

Conclusion: Sample-based estimates of central line-days can yield results that are acceptable for surveillance of healthcare-associated bloodstream infections.

MeSH terms

  • Adult
  • Bacteremia / epidemiology*
  • Bacteremia / etiology
  • Blood-Borne Pathogens
  • Catheterization, Central Venous / adverse effects*
  • Centers for Disease Control and Prevention, U.S.
  • Child
  • Cross Infection / blood
  • Cross Infection / epidemiology*
  • Disease Notification
  • Feasibility Studies
  • Humans
  • Intensive Care Units / standards
  • Intensive Care Units / statistics & numerical data*
  • Sampling Studies
  • Seasons
  • Sensitivity and Specificity
  • Sentinel Surveillance*
  • Time
  • United States / epidemiology