Reports on the SIR Rebaseline (2015), risk adjustment, blood and body fluid exposure, and other topics.
Antimicrobial Resistance Topics
- Trimethoprim-sulfamethoxazole resistance patterns among Staphylococcus aureus in the United States, 2012–2018
This report highlights increases in the percentage of methicillin-resistant Staphylococcus aureus pathogens that were not susceptible to trimethoprim-sulfamethoxazole, using data from 3 national databases. Infect Control Hosp Epidemiol 2022.
Reports from the MDRO/CDI Module
- Laboratory-identified (LabID) VRE bacteremia incidence: An SIR prediction model
An analysis of 2017 national vancomycin-resistant enterococci (VRE) bacteremia data reported from acute care hospitals to NHSN’s MDRO/CDI Module. A risk adjustment model is presented, and national and state-level VRE bacteremia SIRs are calculated for 2018. Infect Control Hosp Epidemiol. 2021; 1-5.
- Short Summary: Testing for C. difficile and Standardized Infection Ratios, 2019 [PDF – 250 KB]
Testing for C. difficile typically relies on nonculture-based techniques of enzyme immunoassays (EIAs) and nucleic acid amplification tests (NAATs) for toxigenic C. difficile, used either alone or in combination with one another. These tests vary in sensitivities, specificities, and clinical implications depending on test type and manufacturer. For this reason, NHSN’s risk-adjusted standardized infection ratio (SIR) for CDI takes into account the test type in use as reported by each facility. Nevertheless, representatives from some facilities have expressed concern that their choice of test type is driving their performance more than their actual burden of infection. In addition, some facilities deploy a multi-step testing algorithm that uses more than one test type. Starting in January 2018, NHSN adjusted its CDI surveillance protocol by stipulating that when facilities use a multi-step testing algorithm on the same stool specimen, the result of the last test performed, as documented in the medical record, determines whether facilities’ CDI rates are adjusted by toxin EIA or by NAAT.
These analyses of CDI data reported by thousands of acute-care hospitals to NHSN indicate that using the NAAT did not statistically inflate the SIR versus using EIA. While any individual acute-care hospital may have improved their SIR (or worsened it) by switching to EIA, acute-care hospitals switching to EIA did not preferentially improve their performance based on changing test type alone.
2015 National SIR and SUR Baseline
- SIR Guide [PDF – 3 MB]
- SUR Guide [PDF – 1 MB]
Historical SIR Baselines
- Risk Adjustment for Healthcare Facility-Onset C. difficile and MRSA Bacteremia Laboratory-identified Event Reporting in NHSN (2010-2011) [PDF – 500 KB]
This report describes the risk modeling that CDC applied to LabID event CDI and MRSA bacteremia data submitted to NHSN, the results of which have been incorporated into the analysis options in the NHSN application.
- Improving Risk-Adjusted Measures of Surgical Site Infection for the NHSN (2006-2008) [PDF – 600 KB]
Infect Control Hosp Epidemiol 2011;32(10):970-986.
Blood and Body Fluid Exposure
- Summary Report for Blood and Body Fluid Exposure Data Collected from Participating Healthcare Facilities (June 1995 through December 2007) [PDF – 3 MB]
This report describes to the public health, the occupational health and safety, and infection control communities, the variety of occupational exposures to blood and body fluids that occur among healthcare providers (HCP).
The National Surveillance System for Healthcare Workers (NaSH) was a voluntary surveillance system developed by the Centers for Disease Control and Prevention (CDC) to systematically collect information important to the prevention of occupational exposures and infections among healthcare personnel (HCP).
NaSH was established in 1995 by the Hospital Infections Program, National Center for Infectious Disease, in consultation with other divisions and institutes within CDC. NaSH collected surveillance data through 2007, and became a legacy system to the web-based National Healthcare Safety Network (NHSN) Healthcare Personnel Safety Component which was launched in August 2009.