Episode of healthcare-associated Staphylococcus aureus bloodstream infection
Identifying and definitional attributes
|Metadata item type:||Glossary Item|
A patient episode of a Staphylococcus aureus bloodstream infection (SABSI) is a positive blood culture for Staphylococcus aureus (S. 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 a subsequent episode is recorded.
A SABSI is healthcare-associated if Criterion A1 or 2, or Criterion B1, 2, 3 or 4 are met.
CRITERION A: The patient’s first Staphylococcus aureus positive blood culture was collected:
A1. > 48 hours after admission, with no documented evidence that infection was present (including incubating) on admission
A2. < 48 hours after discharge.
CRITERION B: The patient’s first positive Staphylococcus aureus blood culture was collected ≤ 48 hours after admission and one or more of the following key clinical criteria is met:
B1. SABSI is a complication of the presence of an indwelling medical device
B2. SABSI occurs within 30 days of a surgical procedure where the SABSI is related to the surgical site, or 90 days for deep incisional/organ space infections related to a surgically implanted device
B3. SABSI was diagnosed within 48 hours of a related invasive instrumentation or incision
B4. SABSI is associated with neutropenia* contributed to by cytotoxic therapy and is unrelated to the presence of an indwelling medical device.
If neither Criterion A1 or 2, nor Criterion B1, 2, 3 or 4 are met, then the SABSI is considered to be community-acquired for the purposes of surveillance.
**Neutropenia is defined as at least two separate calendar days with values of absolute neutrophil count (ANC) or total white blood cells count (WBC) <500 cells/mm3 (<0.5 X 109/L) on or within a seven-day time period which includes the date the positive blood specimen was collected (Day 1), the three calendar days before and the three calendar days after.
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