anged from 0.12 among patients with arteriovenous fistulas to 0.80 among patients with central venous catheters.Rates of bloodstream infection were lower than predicted overall and in almost all states and territories. Background Approximately 500,000 people in the United States undergoing hemodialysis are at risk of bloodstream infections (BSIs). The Centers for Disease Control and Prevention's National Healthcare Safety Network conducts surveillance for BSIs among outpatient hemodialysis facilities in the United States. Quality improvement initiatives encourage these facilities to adopt evidence-based interventions to decrease the incidence of BSI in patients. We describe the incidence of BSI among patients at outpatient hemodialysis facilities in the United States during 2020, stratified by state or territory. Methods Outpatient hemodialysis facilities report BSI events to the National Healthcare Safety Network. Pooled mean rates with 95% confidence interval (CI) were calculated overall and for each type of vascular access (arteriovenous [AV] fistula, AV graft, or a central venous catheter). Standardized infection ratios (SIRs) were calculated as observed BSI events divided by the predicted number of events on the basis of national aggregate data. Median facility-level SIRs and 95% CIs were stratified by state and US territory. Results During 2020, 7183 outpatient hemodialysis facilities reported data for 5,235,234 patient-months with 15,181 BSI events. Pooled mean rates per 100 person-months were 0.29 (95% CI, 0.29 to 0.30) overall, 0.80 (95% CI, 0.78 to 0.82) for central venous catheter, 0.12 (95% CI, 0.12 to 0.12) for AV fistula, 0.21 (95% CI, 0.20 to 0.22) for AV graft, and 0.28 (95% CI, 0.19–0.40) for other access types. The national SIR was 0.40 (95% CI, 0.39 to 0.41). South Dakota had a SIR significantly higher than one (1.34; 95% CI, 1.11 to 1.62). Fifty-one of 54 states and territories had BSI SIR significantly lower than one. Conclusions In 2020, the median SIR for BSI in US outpatient hemodialysis facilities was lower than predicted overall and in almost all states and territories. An elevated SIR was identified in South Dakota....

中文翻译：

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美国血液透析设施血流感染的六年随访，国家医疗安全网络，2020 年


动静脉瘘患者的感染率为 0.12，中心静脉导管患者的感染率为 0.80。几乎所有州和地区的总体血流感染率均低于预期。背景 在美国，大约 500,000 名接受血液透析的人面临血流感染 (BSI) 的风险。美国疾病控制与预防中心的国家医疗安全网络对美国门诊血液透析机构中的 BSI 进行监测。质量改进举措鼓励这些机构采取循证干预措施，以降低患者 BSI 的发生率。我们描述了 2020 年美国门诊血液透析机构患者的 BSI 发病率，按州或地区分层。方法 门诊血液透析机构向国家医疗安全网络报告 BSI 事件。对每种类型的血管通路（动静脉 [AV] 瘘、AV 移植物或中心静脉导管）总体计算了具有 95% 置信区间 (CI) 的合并平均率。标准化感染率 (SIR) 的计算方法为观察到的 BSI 事件除以基于国家汇总数据的预测事件数。设施级 SIR 和 95% CI 中位数按州和美国领土进行分层。结果 2020 年，7183 家门诊血液透析机构报告了 5,235,234 患者月的数据，共发生 15,181 起 BSI 事件。每 100 人月的合并平均率为 0.29（95% CI，0.29 至 0.30），中心静脉导管为 0.80（95% CI，0.78 至 0.82），AV 瘘为 0.12（95% CI，0.12 至 0.12）， AV 移植物为 0.21（95% CI，0.20 至 0.22），其他通路类型为 0.28（95% CI，0.19-0.40）。全国 SIR 为 0.40（95% CI，0.39 至 0.41）。南达科他州的 SIR 显着高于 1（1.34；95% CI，1.11 至 1.62）。 54 个州和地区中有 51 个的 BSI SIR 显着低于 1。结论 2020 年，美国门诊血液透析机构的 BSI 中位 SIR 低于总体预测，几乎所有州和地区均低于预测。南达科他州发现 SIR 升高......