NDLI: Performance characteristics and associated outcomes for an automated surveillance tool for bloodstream infection.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ridgway, Jessica P. Sun, Xiaowu Tabak, Ying P. Johannes, Richard S. Robicsek, Ari
Description	Author Affiliation: Ridgway JP ( Department of Medicine, University of Chicago, Chicago, IL. Electronic address: jessica.ridgway@uchospitals.edu.); Sun X ( CareFusion-BD, San Diego, CA.); Tabak YP ( CareFusion-BD, San Diego, CA.); Johannes RS ( CareFusion-BD, San Diego, CA.); Robicsek A ( Department of Medicine, NorthShore University HealthSystem, Evanston, IL)
Abstract	BACKGROUND: The objective of this study was to evaluate performance metrics and associated patient outcomes of an automated surveillance system, the blood Nosocomial Infection Marker (NIM). METHODS: We reviewed records of 237 patients with and 36,927 patients without blood NIM using the National Healthcare Safety Network (NHSN) definition for laboratory-confirmed bloodstream infection (BSI) as the gold standard. We matched cases with noncases by propensity score and estimated attributable mortality and cost of NHSN-reportable central line-associated bloodstream infections (CLABSIs) and non-NHSN-reportable BSIs. RESULTS: For patients with central lines (CL), the blood NIM had 73.2% positive predictive value (PPV), 99.9% negative predictive value (NPV), 89.2% sensitivity, and 99.7% specificity. For all patients regardless of CL status, the blood NIM had 53.6% PPV, 99.9% NPV, 84.0% sensitivity, and 99.9% specificity. For CLABSI cases compared with noncases, mortality was 17.5% versus 9.4% (P = .098), and median charge was \$143,935 (interquartile range [IQR], \$89,794-\$257,447) versus \$115,267 (IQR, \$74,937-\$173,053) (P < .01). For non-NHSN-reportable BSI cases compared with noncases, mortality was 23.6% versus 6.7% (P < .0001), and median charge was \$86,927 (IQR, \$54,728-\$156,669) versus \$62,929 (IQR, \$36,743-\$115,693) (P < .0001). CONCLUSIONS: The NIM is an effective screening tool for BSI. Both NHSN-reportable and nonreportable BSI cases were associated with increased mortality and cost.
File Format	HTM / HTML
ISSN	01966553
Issue Number	5
Journal	American Journal of Infection Control
Volume Number	44
e-ISSN	15273296
Language	English
Publisher	Elsevier
Publisher Date	2016-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Communicable Diseases
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Public Health, Environmental and Occupational Health Epidemiology Health Policy

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