Objective: Evaluate the use and interpretation of the CDC CLA-BSI definition in the oncology population among different hospitals.
Methods: Teaching hospitals that provide oncology services, including but not limited to hematologic malignancy, were asked to respond to a survey with standardized questions. The questions in the survey addressed how the NHSN CLA-BSI definition was applied when determining the presence of a primary CLA-BSI, and whether or not mucositis and/or graft vs host disease (GVHD) was considered in determining whether a CLA-BSI was primary or secondary.
Results: A total of 22 hospitals across the country were surveyed and 11 responses were received (50%). All hospitals treat patients with various malignancies including but not limited to hematologic malignancies and bone marrow transplant (BMT). The average number of beds was 814. Nine of the 11 responses followed NHSN definitions (81%) and 10 out of the 11 responses (90%) did not consider or stratify by GVHD or mucositis when determining whether a CLA-BSI is primary or secondary. Only 2 out of 11 (18%) surveyed felt that the NHSN definition, as it is currently written, appropriately captures CLA-BSIs in the oncology population. However, 11 out of 11 (100%) of the responders agreed that more specific definitions need to be developed in order to assess CLA-BSI in the oncology population.
Conclusions: In this small survey of tertiary care medical centers, infection prevention and control groups reported varying interpretations of the NHSN definition to identify and classify CLA-BSIs in oncology patients. There was unanimous consensus that more specific criteria need to be developed to address uniformity in identifying primary CLA-BSIs in the oncology population. Academics, SHEA, and APIC need to work with the CDC to better adapt the CLA-BSI definition to this and other special patient populations.