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

To evaluate hospital-onset bacteremia and fungemia (HOB) rates and establish a framework for monitoring this new quality measure.

Approach:
  • Study Design: A population-level retrospective cohort study was conducted examining HOB rates in acute-care hospitals throughout Ontario, Canada, using linked administrative databases.
  • Data Collection: The study evaluated approximately 3.3 million admissions across 114 acute care hospitals from 2017 to 2024, defining HOB as a positive blood culture obtained on or after hospital day 4.
Key Findings:
  • The overall HOB rate was 2.07 events per 1000 patient-days.
  • Elevated HOB rates were associated with factors such as long-term dialysis, active malignant neoplasm, and more frequent blood culture testing.
  • Patient and hospital characteristics explained 71.1% of the variance in HOB event rates.
  • Substantial between-hospital variation in HOB rates persisted even after adjustment for characteristics.
Limitations:
  • The study was conducted in Ontario, Canada, which may limit generalizability to other regions.
  • NHSN-tracked HAI quality metrics lack sufficient patient-level variables for accurate risk adjustment.
Sources:

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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