Ten-year surveillance of central line–associated bloodstream infections in South Korea: Surveillance not enough, action needed

•Central line-associated bloodstream infections are important and preventable healthcare-associated infections.•Participation in continous national surveillance leads to a significant reduction of CLABSIs.•Further improvements in policy support for hospitals lacking infection control resources are n...

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Bibliographic Details
Published in:American journal of infection control 2020-03, Vol.48 (3), p.285-289
Main Authors: Kim, Eun Jin, Kang, So Young, Kwak, Yee Gyung, Kim, Sung Ran, Shin, Myoung Jin, Yoo, Hyeon Mi, Han, Su Ha, Kim, Dong Wook, Choi, Young Hwa
Format: Article
Language:English
Subjects:
Bacteremia - epidemiology
Blood stream infections
Catheter-Related Infections - epidemiology
Catheterization, Central Venous - adverse effects
Cross Infection - epidemiology
Epidemiological Monitoring
Healthcare-associated infections
Hospitals - statistics & numerical data
Humans
Infection Control - statistics & numerical data
Intensive care units
Intensive Care Units - statistics & numerical data
Korean National Healthcare-associated Infections Surveillance System (KONIS)
Prospective Studies
Republic of Korea - epidemiology
Sepsis - epidemiology
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Summary:•Central line-associated bloodstream infections are important and preventable healthcare-associated infections.•Participation in continous national surveillance leads to a significant reduction of CLABSIs.•Further improvements in policy support for hospitals lacking infection control resources are needed. Central line–associated bloodstream infections (CLABSIs) are preventable health care–associated infections that can lead to increased mortality. Therefore, we investigated trends in CLABSI rates, and the factors associated with changing trends over a 10-year period using the Korean National Healthcare-associated Infections Surveillance System (KONIS). We investigated annual CLABSI rates from 2006 to 2015 in 190 KONIS-participating intensive care units (ICUs) from 107 participating hospitals. We collected data associated with hospital and ICU characteristics and analyzed trends using generalized autoregressive moving average models. The CLABSI pooled mean rate decreased from 3.40 in 2006 to 2.20 in 2015 (per 1,000 catheter-days). The trend analysis also showed a significant decreasing trend in CLABSI rates in unadjusted models (annual increase, –0.137; P < .001). After adjusting for hospital and ICU characteristics, significant decreasing trends were identified (annual increase, –0.109; P < .001). However, there were no significant changes in subgroups with non-university-affiliated hospitals, hospitals in metropolitan areas near Seoul, small hospitals (300-699 beds), or surgical ICUs. In South Korea, CLABSI rates have shown significant reductions in the past 10 years with participation in the KONIS. However, CLABSI rates may be reduced by encouraging more hospitals to participate in the KONIS and by improved policy support for hospitals lacking infection control resources.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2019.07.020