Eun Jin Kim1, So Young Kang2, Yee Gyung Kwak3, Sung Ran Kim4, Myoung Jin Shin5, Hyeon Mi Yoo6, Su Ha Han7, Dong Wook Kim8, Young Hwa Choi9. 1. Department of Infectious Diseases, Ajou University School of Medicine, Suwon, South Korea. 2. Office of Biostatistics, Institute of Medical Sciences, Ajou University School of Medicine, Suwon, South Korea. 3. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea. 4. Infection Control Office, Korea University Guro Hospital, Seoul, South Korea. 5. Infection Control Office, Seoul National University Bundang Hospital, Seongnam, South Korea. 6. Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, South Korea. 7. Department of Nursing, Soonchunhyang University College of Medicine, Cheonan, South Korea. 8. Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, South Korea. 9. Department of Infectious Diseases, Ajou University School of Medicine, Suwon, South Korea. Electronic address: yhwa1805@aumc.ac.kr.
Abstract
BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Keywords:
Blood stream infections; Healthcare-associated infections; Intensive care units; Korean National Healthcare-associated Infections Surveillance System (KONIS)