1st Annual Illinois Conference on HAI: The SSI rates don't exist anymore edition



I ate all of the Illinois-shaped
chocolates. Sorry!

I had the pleasure of attending and speaking at the Illinois APIC conference this past Friday in Springfield, Illinois.  Lincoln was everywhere for some reason; I was expecting Homer or Bart statues...

The first speaker was Kathy Allen-Bridson, RN BSN CIC who is a Nurse Consultant at CDC's NHSN.  She gave an excellent talk describing how to apply NHSN definitions. She, Marc Wright (one of the conference organizers), Joan Hebden, Gloria Morrell and Teresa Horan have published a series of cases studies that aid IPs in the application of NHSN definitions of HAIs.  The first three of these have appeared in the June, September and October issues of APIC. (scroll down to the Special Article section)  I do think that these should be free to everyone and not require a membership or subscription, especially given the large role that CDC had in creating these vignettes.

As far as CLABSI definitions, there was some interesting discussion around Criterion 2 that requires the "same" skin contaminant from >2 blood cultures drawn <2 days apart. For the definition of same, NHSN suggests

that organisms are the same if they have the same antimicrobial sensitivities or only differ in susceptibility to ONE antibiotic.  Thus if they differ by 2 or more antibiotic susceptibilities then they are different and the BSI is not a CLABSI.  The interesting discussion came up around what to do with susceptibilities tested by the microbiology lab, but not reported.  Since some/many labs only report susceptibilities to clinicians for antibiotics on formulary or unrestricted antibiotics, should IPs go to the lab and search for susceptibility mismatch on antibiotics tested in the lab but not reported?  A show of hands suggested that 50% do the extra search and 50% don't.  This is something NHSN might want to address.