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‘Significant gaps’ found in MRSA BSI reporting from hemodialysis facilities
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A significant number of MRSA bloodstream infections in hospitals serving chronic hemodialysis patients in 2013 were not reported to the CDC, according to a report published in Infection Control and Hospital Epidemiology.
In 2012, CMS began to reimburse outpatient dialysis facilities based on their participation in the CDC’s National Healthcare Safety Network Dialysis Event (NHSN DE) surveillance system. Researchers, including Infectious Disease News Editorial Board member William Schaffner, MD, of Vanderbilt University School of Medicine, said these data will be used to measure performance and disease burden. However, most of these facilities are new to the NHSN DE system.
William Schaffner
Therefore, the researchers compared reporting of MRSA bloodstream infections (BSI) among chronic hemodialysis patients to the NHSN DE and the CDC’s Emerging Infections Program (EIP), a surveillance network active in California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, Oregon and Tennessee since 2005.
According to the researchers, 694 cases of MRSA BSI among chronic hemodialysis patients were reported to the EIP in 2013. That same year facilities within the EIP surveillance territory reported 141 MRSA BSI to the NHSN DE, and dialysis facilities within the EIP catchment area reported 9,943 dialysis events to the NHSN DE.
The researchers’ analysis showed that only 11% of MRSA BSI reported to the EIP could be matched to a corresponding report at the NHSN DE. An additional 64 MRSA BSI reports submitted to EIP matched a Staphylococcus aureus report filed with the NHSN DE, the researchers said.
“Among the 64 MRSA BSI from EIP that matched only non-MRSA S. aureus BSI from NHSN DE, 60 (94%) did not have any cefoxitin, oxacillin or methicillin susceptibility data reported in NHSN,” the researchers wrote.
Of those EIP reports without matching NHSN DE reports of S. aureus BSI, the researchers found 144 corresponding reports of IV vancomycin starts filed with the NHSN DE. In all, 41% of EIP MRSA BSI reports corresponded with an NHSN DE report.
“We observed significant gaps in reporting of MRSA BSI from outpatient hemodialysis facilities to NHSN DE, particularly for MRSA BSI identified at the start of a hospitalization,” the researchers wrote. “Improved communication and data sharing between hospitals and dialysis facilities are needed to increase the usefulness of NHSN DE data.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
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