Dr Ruth Barratt1, Dr Sally Roberts1,2, Ms Nikki Grae1, Ms Barbara Gibson1,3, Ms Grace Clendon1
1Health Quality & Safety Commission, New Zealand, Wellington, New Zealand
2Microbiology, LabPlus, Auckland District Health Board, Auckland, New Zealand
3Nelson Marlborough District Health Board, Nelson, New Zealand
Introduction: Staphylococcus aureus is a major cause of both community-acquired and healthcare-associated bacteraemia worldwide. It is associated with significant morbidity and mortality. Key sources for healthcare-associated S. aureus bacteraemia (HA-SAB) infections include vascular access devices, medical procedures and surgical site infections. HA-SAB rates for District Health Board (DHB) hospitals in New Zealand are reported through the Health Quality and Safety Commission (HQSC) as a quality and safety measure. Since 2016 the national DHB rate has increased from 0.11 to 0.15 events per 1000 bed days. Information on the source of infection is limited. The primary aim was to identify the source of HA-SAB in DHB hospitals to inform future national quality improvement activities.
Method: De-identified HA-SAB event source data was requested from DHBs for the period 1 January 2017 to 30 June 2021. Data was categorised and analysed to identify trends and significant sources contributing to HA-SAB events.
Results: There were 1,867 HA-SAB events. The principal sources of HA-SAB were medical devices (65%), surgical site infection (10%), and organ site (8%). The majority, 95%, of medical devices were for vascular access; central venous catheters (50%) and peripheral intravenous catheters (PIVC) (45%). There was a significant increase in PIVC-related HA-SAB (34% to 46%, p< 0.01) over this period.
Conclusion: Vascular access devices are the main source of HA-SAB in DHB hospitals. A national quality improvement (QI) programme focused on the implementation of best practice for PIVC use is required. Ongoing surveillance of HA-SAB, including the source, will support this QI programme.
Biography: Ruth is a registered nurse and is credentialed at expert level in infection prevention and control through ACIPC. She holds a PhD through the University of Sydney and a masters in infection prevention and control. Ruth has more than 24 years’ experience in this field across the private and public sectors in New Zealand and Australia, and has authored a number of journal publications. Her IPC interests include healthcare associated infection surveillance and device-related infections. Ruth is currently working as an IPC specialist with the Health Quality and Safety Commission in New Zealand and a private consultant for IPC.