A/Prof Leon Worth1, Dr Stephanie Tanamas1, Dr Lyn-li Lim1, Dr Michael Molloy1, Dr Ann Bull1, A/Prof. Deb Friedman1
1VICNISS, Melbourne, Australia
Biography:
A/Professor Deborah Friedman is the director of VICNISS, who coordinate and report healthcare-associated infection (HAI) surveillance data in Victoria. She received her Infectious Diseases Fellowship at Duke University Medical Center, and her research in the area of infections that develop in hospitalised patients, defined the term healthcare-associated infection.
She received her MD in the area of Infection Control and hospital-acquired infections and completed a Masters of Public Health. She has authored over 100 publications and is an appointed member of the Healthcare infection control special interest group (HICSIG), and an editorial board member for American Journal of Infection Control.
Abstract:
Introduction
Following the introduction of standardised national reporting of healthcare-associated SAB (HA-SAB) in 2011, surveillance continues as a performance measure for hospitals. We will present longitudinal trends in SAB rates (2011-2023) and the enhanced monitoring framework used to support quality improvement within Victorian healthcare facilities.
Methods
In Victoria, all cases of SAB are submitted to VICNISS, the coordinating centre for healthcare-associated infection surveillance. Nationally accepted definitions of HA-SAB are employed, including identification of cases where the positive blood culture was collected more than 48 hours after hospital admission or less than 48 hours after discharge. Cases of community-associated SAB (CA-SAB) are also reported to contextualise disease trends. Enhanced monitoring includes both standardised assessment of preventability, and additional fields for risk factors and clinical characteristics of SAB cases.
Results
State-wide surveillance demonstrated reductions in SAB rates over the first 5 years, particularly notable within methicillin-resistant SAB. Of all cases reported in 2023, 1,334 were CA-SAB and 536 were HA-SAB, with the Statewide aggregate for HA-SAB being 0.6/10,000 occupied-bed-days. 54% of HA-SAB cases were device-associated, (31% peripheral and 19% central venous catheters), 22% were early events (<48 hours after admission) and 78% were late events (>48 hours after admission). Expanded risk factor evaluation is ongoing.
Conclusions
Refinement to SAB surveillance is a necessary step following early reductions in the burden of illness, enabling clinically relevant factors to be identified, and preventability of cases, including CA-SAB cases, to be assessed. These are important for all healthcare facilities in implementing quality improvement programs.