Surveillance of healthcare associated infection: Staphylococcus aureus bacteraemia NBPDS

Identifying and definitional attributes

• Health, Standard 15/11/2012

The purpose of this National best practice data set (NBPDS) is to support a comprehensive surveillance program of healthcare associated infections (HAI). HAIs are those infections that are not present or incubating at the time of admission to a healthcare program or facility, develop within a healthcare organisation or are produced by micro-organisms acquired during admission.

This NBPDS is intended to support Staphylococcus aureus bacteraemia (SAB) surveillance in Australian hospitals. It is designed for the purposes of HAI surveillance, not diagnosis. The value of surveillance as part of a hospital infection control program is supported by high-grade international and national evidence.

This NBPDS supports development of local forms and systems for surveillance of HAIs and associated data collection. This NBPDS applies to patient episodes of SAB in Australian hospitals.

Case Definition – Healthcare associated Staphylococcus aureus bacteraemia (SAB)

A patient-episode of Staphylococcus aureus bacteraemia (SAB) is a positive blood culture for Staphylococcus aureus.

For surveillance purposes, only the first isolate per patient is counted, unless at least 14 days has passed without a positive culture, after which an additional episode is recorded.

A SAB will be considered to be a healthcare-associated event if:

EITHER

• CRITERION A. The patient’s first SAB positive blood culture was collected more than 48 hours after hospital admission or less than 48 hours after discharge.

OR

• CRITERION B. The patient’s first positive SAB blood culture was collected less than or equal to 48 hours after hospital admission and one or more of the following key clinical criteria was met for the patient-episode of SAB:

1. SAB is a complication of the presence of an indwelling medical device (e.g. intravascular line, haemodialysis vascular access, CSF shunt, urinary catheter)
2. SAB occurs within 30 days of a surgical procedure where the SAB is related to the surgical site
3. SAB was diagnosed within 48 hours of a related invasive instrumentation or incision
4. SAB is associated with neutropenia (Neutrophils: less than 1 x 10⁹/L) contributed to by cytotoxic therapy

In order for jurisdictions and private hospital ownership groups to accurately report and monitor Healthcare Associated Infections, the data elements listed should be collected at hospital level for each patient-episode of Staphylococcus aureus bacteraemia. HAI patient episode data elements for SAB, by short name

Collection and usage attributes

Episodes of infection (Staphylococcus aureus bacteraemia (SAB))

Surveillance data should be used to identify local problem areas and implement appropriate policy and clinical interventions to improve the quality of care, not for external benchmarking. Effective surveillance systems provide the impetus for change and make it possible to evaluate the effectiveness of interventions. An effective surveillance system is one that provides timely and reliable information to hospital managers and clinicians to effectively manage HAI.

Surveillance is an important tool to reduce HAI. The purpose of collecting, analysing, and then acting on reliable surveillance data is to improve quality and patient safety within a service or facility or jurisdiction.

Source and reference attributes

Australian Commission on Safety and Quality in Health Care (ACSQHC)

ACSQHC Healthcare Associated Infection Advisory Committee's Technical Working Group

Relational attributes