Charting a Path Forward for National Surveillance of Hospital-Onset Bacteremia and Fungemia - Scorecard - MDSpire
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Establishing a Framework for National Monitoring of Hospital-Acquired Bacteremia and Fungemia

  • By

  • Gregory M. Schrank

  • September 9, 2026

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Clinical Scorecard: Establishing a Framework for National Monitoring of Hospital-Acquired Bacteremia and Fungemia

At a Glance

CategoryDetail
ConditionHospital-onset bacteremia and fungemia (HOB)
Key MechanismsCaptures nosocomial bloodstream infections without regard to device presence or recent procedures.
Target PopulationPatients in acute-care hospitals.
Care SettingHospital settings with a focus on infection surveillance.

Key Highlights

  • HAI rates in the US have improved, with a 27% reduction in prevalence since 2015.
  • HOB serves as a new quality measure for bloodstream infections.
  • The overall HOB rate was 2.07 events per 1000 patient-days in Ontario hospitals.
  • Elevated HOB rates are associated with factors like long-term dialysis and active malignant neoplasm.
  • Blood culture testing prevalence is linked to HOB incidence.

Guideline-Based Recommendations

Diagnosis

  • HOB defined as a positive blood culture for any bacterium or fungus obtained on or after hospital day 4.

Management

  • Monitor blood culture contamination in addition to true pathogens.

Monitoring & Follow-up

  • Incorporate patient and hospital characteristics in HOB surveillance models.

Risks

  • Insufficient risk adjustment may lead to underestimation of HAI events.

Patient & Prescribing Data

Patients admitted to acute-care hospitals.

Excessive antimicrobial exposure may occur due to blood culture contamination.

Clinical Best Practices

  • Utilize comprehensive data linkage for risk adjustment in HOB surveillance.
  • Implement automated electronic data linkage to enhance quality measures.

Related Resources & Content

Original Source(s)

Charting a Path Forward for National Surveillance of Hospital-Onset Bacteremia and Fungemia

  • by Gregory M. Schrank

  • September 9, 2026

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