Table 1

Operational definitions specific to BSI/CLABSI surveillance13

Primary BSIA laboratory-confirmed bloodstream infection that is not secondary to an infection at another body site
Secondary BSIA BSI that is thought to be seeded from a site-specific infection at another body site
CLABSI rateThe total no of CLABSIs divided by the total no of device days × 1000
AccessThe performance of any of the following activities during in-patient admission:
  • Line placement

  • Use of (entering the line with a needle or needless device) any central line for:

  • Infusion

  • Withdrawal of blood

  • Haemodynamic monitoring

Central line (CL):An intravascular catheter that terminates at or close to the heart, or in one of the great vessels used for infusion, the withdrawal of blood, or haemodynamic monitoring. The following great vessels should be considered when making determinations regarding CLABSI events and counting CL device days:
  • Aorta

  • Pulmonary artery

  • Superior vena cava

  • Inferior vena cava

  • Brachiocephalic veins

  • Internal jugular veins

  • Subclavian veins

  • External iliac veins

  • Common iliac veins

  • Femoral veins

Eligible CLA CL that has been in place for more than two consecutive calendar days (on or after CL day 3), following first access to the central line during the current admission. Such lines are eligible for CLABSI events and remain eligible for CLABSI events until the day after its removal from the body or patient discharge, whichever comes first.
Denominator device daysThe count of central lines for an in-patient unit that is recorded in monthly denominator summary data
Types of central lines for NHSN reporting purposes:
  1.  A permanent central line includes: (1) tunnelled catheters, including tunnelled dialysis catheters (2) implanted catheters (including ports)

  2.  Temporary central line: a non-tunnelled, non-implanted catheter

Devices not considered CLs for NHSN reporting purposes:
  • Arterial catheters

  • Arteriovenous fistula

  • Arteriovenous graft

  • Atrial catheters (also known as transthoracic intracardiac catheters, which are inserted directly into the right or left atrium via the heart wall)

  • Extracorporeal membrane oxygenation

  • Haemodialysis reliable outflow dialysis catheter

  • Intraaortic balloon pump devices

  • Peripheral intravenous or midlines

  • Ventricular assist devices

  • BSI, bloodstream infection; CLABSI, central line-associated bloodstream infection; NHSN, National Healthcare Safety Network.