Pilot validation of central line-associated bloodstream infection data in a voluntary surveillance system in Taiwan between October and December 2021

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2023-11-10 DOI:10.1016/j.infpip.2023.100326
Hao-Hsin Wu , Shu-Ling Chang , Chiu-Hsia Su , Shu-Hui Tseng , Li-Jung Chien
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Abstract

Background

Central line-associated bloodstream infection (CLABSI) surveillance data are voluntarily submitted to the Taiwan Healthcare-associated Infection and Antimicrobial Resistance Surveillance (THAS) System. Validation of the CLABSI data is important to ensure the quality of surveillance data. We aimed to validate the CLABSI surveillance data reported to the THAS system.

Methods

This study was a retrospective medical record review of patients with positive blood cultures admitted to the intensive care units (ICUs) of 13 participating hospitals between October and December 2021. An external validation team was convened to perform the validation process according to the standardised protocol and to record the reasons for misclassification.

Discussion

During the study period, 688 patients with 1,238 positive blood cultures from 59 ICUs at 13 hospitals were evaluated. Among the 185 potential CLABSI events which met the THAS definition by either the external reviewers or the hospital reviewers, 24 (13.0%) events were identified by only the external reviewers, and six (3.2%) were identified by only the hospital reviewers, with an agreement rate of 83.8%. Using external reviewers as the gold standard, the pooled mean sensitivity and positive predictive value of CLABSI reporting were 86.6% (155/179) and 96.3% (155/161), respectively. Among the 37 misclassification episodes, missed case findings were the most common reason for misclassification (N=16, 43.2%).

Conclusions

The CLABSI data reported to the THAS system are generally reliable. This study showed the need for ongoing validation processes and quality improvement to maintain the accuracy and validity of the surveillance data.

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2021年10月至12月在台湾自愿监测系统中对中心线相关血流感染数据进行试点验证
中心静脉相关血流感染(CLABSI)监测数据自愿提交给台湾卫生保健相关感染和抗菌素耐药性监测(THAS)系统。CLABSI数据的验证对于确保监测数据的质量非常重要。我们的目的是验证报告给THAS系统的CLABSI监测数据。本研究是对13家参与医院2021年10月至12月入住重症监护病房(icu)的血培养阳性患者的回顾性医疗记录进行审查。召集外部验证小组,根据标准化方案执行验证过程,并记录错误分类的原因。在研究期间,对来自13家医院59个icu的688例患者的1238例血培养阳性进行了评估。在185个外部审稿人或医院审稿人符合THAS定义的潜在CLABSI事件中,24个(13.0%)事件仅由外部审稿人确定,6个(3.2%)事件仅由医院审稿人确定,符合率为83.8%。以外部审稿人为金标准,CLABSI报告的汇总平均敏感性和阳性预测值分别为86.6%(155/179)和96.3%(155/161)。在37例误诊事件中,漏诊是最常见的误诊原因(n=16, 43.2%)。向THAS系统报告的CLABSI数据通常是可靠的。这项研究表明需要持续的验证过程和质量改进,以保持监测数据的准确性和有效性。
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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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