Outcomes
fever, infection, hypotension, gram-negative, chills
INFECTION, NOSOCOMIAL INFECTIONS
This post-hoc before-after analysis of the CLIP-ID cRCT is based on data provided by ICU-KISS, the German national surveillance system for nosocomial infections. Trained nurses and doctors conduced unit-based surveillance by collecting unit-based, anonymous data on number of patients, patient days, days with medical devices (e.g. mechanical ventilation, central line), and HAI including CLABSI. All definitions and details on unit-based surveillance in ICU-KISS can be found in the ICU-KISS protocol [This analysis was done for the primary outcome CLABSI associated with the stay on a participating ICU standardized by central line (CL)-days. Briefly, the definition of CL association to qualify a CLABSI required the following: CL being present at onset of infection (first day with symptoms) or one day before onset of infection for at least the third day. The association to a participating ICU required acquisition of CLABSI on the third day post admission to the ICU at the earliest, while the day of admission was counted as day 1. Further criteria must be met as described elsewhere [Detection of one or more pathogen(s) in one or more blood samples taken for the purpose of diagnosis or treatment by culture-based or non-culture-based methods and the pathogen identified must not be associated to an infection at another site orDetection of the same skin bacterium in at least two separate blood samples taken for the purpose of diagnosis or treatment by cultural or non-cultural methods and the pathogen identified must not be associated to an infection on another site and at least one of the following signs or symptoms occurred: fever (> 38 °C), chills, hypotension.The number of CLABSI with any pathogen was aggregated by the number of CLABSI with gram-positive, gram-negative bacteria, and CLABSI with other causes (fungi or other than fungi, gram-positive or gram-negative pathogens).Further subgroups analysed were CLABSI with gram-positive bacteria, coagulase-negative staphylococci (CoNS) and gram-negative bacteria.
