CLABSI data inaccuracies
Abstract:
Background: Central line-associated bloodstream infections (CLABSIs) contribute significantly to morbidity, mortality, and health care costs. Despite the availability of standardized surveillance criteria, inconsistencies in CLABSI reporting can lead to inaccuracies in the data used to inform benchmarking, determine economic burden, and prioritize resource allocation. At Lions Gate Hospital (LGH) in Vancouver, British Columbia, anecdotal evidence suggested a discrepancy between CLABSI cases identified by the BC Critical Care Informatics division and those reported by the facility’s Infection Prevention and Control (IPAC) team.
Objectives: To determine whether CLABSI cases reported by Critical Care Informatics and those classified by the facility’s intensive care unit (ICU) team met the Canadian Nosocomial Infection Surveillance Program (CNISP) definition used by IPAC, and to determine reasons for discordance, if present.
Methods: This retrospective chart review examined all cases of CLABSI in the LGH ICU identified by Critical Care Informatics nurses from January 2019 to November 2024. Data were collected for patient demographic characteristics, catheter details, pathogens, anti-infective treatments, and outcomes. The cases were assessed against the CNISP definition of CLABSI, and instances of discordance were identified.
Results: The Critical Care Informatics nurses identified 32 cases of CLABSI during the study period, of which 20 (63%) were also classified as CLABSI by the ICU team. Only 7 cases (representing 22% of the 32 cases identified by Critical Care Informatics and 35% of the 20 cases identified by the ICU team) met the CNISP definition. Reasons for discordance were primary infection at another site, CLABSI not being ICU-related, diagnosis based only on a positive culture tip from the central line, and failure to meet microbiological and/or clinical criteria.
Conclusions: Most reported cases of CLABSI did not meet the CNISP definition, which underscores the need for standardized interpretation of criteria and education.
Reference:
Kanji Z, Bonakdarsakhi S, Douglas J. Discordance in Rates of Central Line-Associated Bloodstream Infection in the Intensive Care Unit (CLABSI-ID Study). Can J Hosp Pharm. 2026 Nov 11;79(4):e3898. doi: 10.4212/cjhp.3898. PMID: 42964964; PMCID: PMC13722487.