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IDCU HomeInfectious Diseases A-C
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Infectious Disease Control Unit
Mail Code: 1960
PO BOX 149347 - Austin, TX 78714-9347

1100 West 49th Street, Suite T801
Austin, TX 78714
Phone: 512 776 7676
Fax: (512) 776-7616
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 Home >
 Infectious Disease Control >
 FAQ about HAI Definitions
HCS Home HAI Home FAQs
HEALTH CARE-ASSOCIATED INFECTION DEFINITIONS
1.
Blood cultures are what determine central line associated bloodstream infections
(CLABSI), correct? Not culturing the tip of the catheter. What is the reasoning behind this?
By National Healthcare Safety Network (NHSN) definition, positive blood culture(s) determine whether an infection is considered a CLABSI or not. A positive catheter tip alone (without positive blood culture) does not meet criteria for CLABSI. In the reporting instructions of the NHSN Manual it states “purulent phlebitis confirmed with a positive semi-quantitative culture of a catheter tip, but with either negative or no blood culture is considered a CVS-VASC, not a BSI.” (Document found at: Central Line-
Associated Bloodstream Infection (CLABSI) Event ). Instead, positive catheter tips may be indications of CVS-VASC, an arterial or venous infection which are counted separately from CLABSIs. ( CDC/NHSN Surveillance Definition of Healthcare-
Associated Infection and Criteria for Specific Types of Infections in the Acute Care
Setting )
2.
What is the NHSN definition of an operative procedure? Answer can be found by clicking on the “SSI protocol” link under reporting on www.HAITexas.org
.
An NHSN operative procedure is a procedure:
1.
That is performed on a patient who is an NHSN inpatient or an NHSN outpatient;
2.
Takes place during an operation (defined as a single trip to the operating room (OR) where a surgeon makes at least one incision through the skin or mucous membrane, including laparoscopic approach, and closes the incision before the patient leaves the OR; and
3.
That is included in Table 1 on the document found at Surgical Site Infection (SSI) Event .

NOTE: If the skin incision edges do not meet because of wires or devices or other objects extruding through the incision, the incision is not considered primarily closed and therefore the procedure is not considered an operation. Further, any subsequent infection is not considered a procedure-associated infection (i.e., not an SSI or PPP).
3.
What is the NHSN definition of a surgical site infection (SSI)? There are 3 types of reportable surgical site infections.
1.
Superficial incisional SSI
2.
Deep incisional SSI
3.
Organ/space SSI
Definitions of the following can be found by clicking on the “SSI protocol” link under reporting on www.HAITexas.org
.
4.
In the SSI definition, one of the criteria for infection is that the incision is
“deliberately opened by surgeon.” Does this HAVE to be a surgeon or can it be a physician?
The wound can be deliberately opened by either a surgeon or a physician to meet the criteria for SSI.
5.
What is the surveillance definition for superficial surgical site infections (SSI)? A superficial incisional SSI must meet one of the following criteria:
Infection occurs within 30 days after the operative procedure and involves only skin and subcutaneous tissue of the incision and patient has at least one of the following: a.
Purulent drainage from the superficial incision. b.
Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision. c.
At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat, and superficial incision is deliberately opened by surgeon, and is culture-positive or not cultured. A culture-negative finding does not meet this criterion. d.
Diagnosis of superficial incisional SSI by the surgeon or attending physician.
NOTE: There are two specific types of superficial incisional SSIs:
1.
Superficial Incisional Primary (SIP) – a superficial incisional SSI that is identified in the primary incision in a patient that has had an operation with one or more incisions (e.g., Csection incision or chest incision for CBGB)
2.
Superficial Incisional Secondary (SIS) – a superficial incisional SSI that is identified in the secondary incision in a patient that has had an operation with more than one incision
(e.g., donor site [leg] incision for CBGB)
Further information can be found by clicking on the “SSI protocol” link under reporting on
HAITexas.org. SSI Protocol .
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Last updated December 01, 2015
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