Background. Regulatory agencies in the United States require hospitals use of the National Healthcare Safety Network (NHSN) definitions for central line associated bloodstream infection (CLABSI) surveillance. In 2015, there were several modifications to the NHSN definition of CLABSI. The objective of this study is to quantify the effect of these modifications on reported CLABSI rates. Methods. We gathered intensive care unit (ICU) CLABSI data from 8 hospitals within a healthcare system and used data from 2014 as a baseline. Both the 2014 and 2015 NHSN CLABSI definitions were applied to the ICU patients in 2015. Infection rates were determined using both definitions for the 2015 patients, and compared to 2014 data using chi square analysis (Epi Info 7). Results. There were 28 CLABSI identified in 2014 baseline data (42,230 central line (cl) days, 0.65 CLABSI per 1000 cl days). In 2015 there were 52 CLABSI cases under the 2015 NHSN definition (43,599 cl days, 1.19 CLABSI per 1000 cl days), but only 32 cases (0.73 CLABSI per 1000 cl days) when the 2014 definition was used. Applying the 2014 definition to both years, there was a 12% increase in CLABSI rate (p = 0.63), which was not statistically significant. The 2015 definition change resulted in an 83% increase in CLABSI rate (p < 0.01). Removal of bronchitis as a cause of secondary bacteremia and the requirement for radiographic evidence of gastrointestinal infection as a cause of secondary bacteremia were the definition changes with the most impact (table). Table: Description of Cases That Were Secondary Bacteremias by 2014 Definition but CLABSI by 2015 Definition Conclusion. The changes to the CLABSI definition in 2015 lead to a significant perceived 83% increase in CLABSI. The impact that this will have on national benchmark data for hospitals is unknown. Disclosures. All authors: No reported disclosures.
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Grimes et al. (2016) studied this question.