ArticleBMJ quality & safety2024
Evaluation of hospital-onset bacteraemia and fungaemia in the USA as a potential healthcare quality measure: a cross-sectional study.
Article in BMJ quality & safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Variability in Hospital-Onset Bacteremia in Ontario.JAMA network open · 2026Article
- Underlying Causes and Preventability of Hospital-Onset Sepsis Events.JAMA network open · 2026Article
- Prevention of arterial catheter-related bloodstream infections: current evidence and future directions.Critical care (London, England) · 2026Review
- Pancreatic Stone Protein as an Emerging Biomarker in Paediatric Nosocomial and Postoperative Sepsis: An Integrative Review of Diagnostic and Prognostic Performance.International journal of molecular sciences · 2026Review
- Development and implementation of a quality improvement framework for the prevention hospital-onset bacteremia and fungemia.Infection control and hospital epidemiology · 2026Article
- Hospital-onset methicillin-resistantInfection control and hospital epidemiology · 2026Article
- Advancing hospital-onset bacteraemia surveillance: a five-year retrospective study following the hospital-wide implementation of an automated surveillance system at a German university hospital.Antimicrobial resistance and infection control · 2026Article
- Reducing home infusion CLABSI through a dashboard and toolkit implementation.Infection control and hospital epidemiology · 2026Article
- The burden of non-CLABSI hospital-onset bloodstream ınfections in pediatric wards outside the ıntensive care units.European journal of pediatrics · 2026Article
- Increased cost of care and length of stay due to potentially preventable catheter-related infections in US inpatient data, 2022-2023.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Mortality and length of stay associated with antimicrobial-susceptible and -resistant hospital-onset bloodstream infections at a tertiary referral hospital in Melbourne, Australia.JAC-antimicrobial resistance · 2025Article
- Letter to the editor: Towards effective implementation of hospital-onset bacteraemia and fungaemia as a quality metric.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Canada-wide bloodstream infectious diseases surveillance: Quantum leap or a baby step toward a comprehensive electronic national infections surveillance system?Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Integrating Nonindividual Patient Features in Machine Learning Models of Hospital-Onset Bacteremia.JAMA network open · 2025Article
- Hospital-onset bacteraemia and fungaemia as a novel automated surveillance indicator: results from four European university hospitals, 2018 to 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Observational
- A review of implementation aspects and sustainability in the prevention of hospital onset bacteremia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
backgroundHospital-onset bacteraemia and fungaemia (HOB) is being explored as a surveillance and quality metric. The objectives of the current study were to determine sources and preventability of HOB in hospitalised patients in the USA and to identify factors associated with perceived preventability.
methodsWe conducted a cross-sectional study of HOB events at 10 academic and three community hospitals using structured chart review. HOB was defined as a blood culture on or after hospital day 4 with growth of one or more bacterial or fungal organisms. HOB events were stratified by commensal and non-commensal organisms. Medical resident physicians, infectious disease fellows or infection preventionists reviewed charts to determine HOB source, and infectious disease physicians with training in infection prevention/hospital epidemiology rated preventability from 1 to 6 (1=definitely preventable to 6=definitely not preventable) using a structured guide. Ratings of 1-3 were collectively considered 'potentially preventable' and 4-6 'potentially not preventable'.
resultsAmong 1789 HOB events with non-commensal organisms, gastrointestinal (including neutropenic translocation) (35%) and endovascular (32%) were the most common sources. Overall, 636/1789 (36%) non-commensal and 238/320 (74%) commensal HOB events were rated potentially preventable. In logistic regression analysis among non-commensal HOB events, events attributed to intravascular catheter-related infection, indwelling urinary catheter-related infection and surgical site infection had higher odds of being rated preventable while events with neutropenia, immunosuppression, gastrointestinal sources, polymicrobial cultures and previous positive blood culture in the same admission had lower odds of being rated preventable, compared with events without those attributes. Of 636 potentially preventable non-commensal HOB events, 47% were endovascular in origin, followed by gastrointestinal, respiratory and urinary sources; approximately 40% of those events would not be captured through existing healthcare-associated infection surveillance. DISCUSSION: Factors identified as associated with higher or lower preventability should be used to guide inclusion, exclusion and risk adjustment for an HOB-related quality metric.
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