TY - JOUR T1 - SUrveillance quality in reporting nosocomial bloodstream infection rates—reply AU - Lin MY AU - Weinstein RA AU - Trick WE Y1 - 2011/02/23 N1 - 10.1001/jama.2011.158 JO - JAMA SP - 779 EP - 780 VL - 305 IS - 8 N2 - In Reply: Drs Cohen and Benenson highlight challenges in assessing central line–associated BSI rates, particularly with respect to denominator measurement. Central line–associated BSI rates are calculated with a denominator of central-line days, which provides important risk adjustment among hospitals that differ in patient severity of illness.1 The denominator reflects “at-risk” days, and theoretically patients with infected central lines should be removed from the denominator.2 However, many patients have more than 1 central line, and these patients remain eligible for additional central line–associated BSIs beyond the first event. Since enumerating central-line days is already labor intensive at most hospitals and the days are often aggregated to the unit level, it is unlikely that achieving a marginally more accurate denominator would meaningfully impact central line–associated BSI rates. For example, since on average less than 1% of central-line days incur an infection, the adjustment would be minimal. SN - 0098-7484 M3 - doi: 10.1001/jama.2011.158 UR - http://dx.doi.org/10.1001/jama.2011.158 ER -