LABORATORY CONFIRMED BLOODSTREAM INFECTION (LCBI) CRITERIA
3. LABORATORY CONFIRMED BLOODSTREAM INFECTION (LCBI) CRITERIA
a. Evaluate all positive blood specimens in order as potential Laboratory Confirmed Bloodstream Infection (LCBI), using table columns below to determine if there was a LCBI, and which type (LCBI 1, LCBI 2 or LCBI 3) was met, if any. All elements listed in a column are required to a. Evaluate all positive blood specimens in order as potential Laboratory Confirmed Bloodstream Infection (LCBI), using table columns below to determine if there was a LCBI, and which type (LCBI 1, LCBI 2 or LCBI 3) was met, if any. All elements listed in a column are required to
element and can bridge to other elements Blastomyces spp., Coccidioides
consecutive days (this is one
either forward or backward). spp., Cryptococcus spp.,
element and can bridge to other
elements either forward or
Histoplasma spp.,
backward).
Paracoccidioides spp., Pneumocystis spp., Salmonella spp.,
Organism(s) identified from blood Organism(s) identified from Organism(s) identified from blood is not
is not related to an infection at
related to an infection at another site. another site.
blood is not related to an
If alternative primary site is likely, If alternative primary site is likely,
infection at another site.
completed 2016 Tennessee checklist is completed 2016 Tennessee
If alternative primary site is
required, with review of NHSN Manual Other site
likely, completed 2016
Appendix 1 secondary BSI Guide .Type of exclusion
checklist is required, with review
Tennessee checklist is required,
alternative primary site infection, date of secondary BSI Guide.
of NHSN Manual Appendix 1
with review of NHSN Manual
alternative primary event, and Appendix 1 Type of alternative primary site
Appendix 1 secondary BSI Guide.
criterion should be recorded under infection, date of alternative
Type of alternative primary site
outcomes on p 4. primary event, and Appendix 1
infection, date of alternative
primary event, and Appendix 1
criterion should be recorded under
criterion should be recorded outcomes on p 4. under outcomes on p 4.
( Infant ≤1 year of age) Age and
(Any Age)
(Any Age)
(Any symptom or No Symptoms/Signs)
At least ONE of:
At least ONE of:
Symptoms/
Fever >38.0°C Signs
Fever >38.0°C
Hypothermia <36.0° element
Chills, or
Hypotension
Apnea, or Bradycardia
All LCBI 2 elements must occur
within the Infection Window
All LCBI 3 elements must occur within a
the Infection Window Period, the seven- Timeframe
Period, the seven-day time
(NA)
period which includes the date
day time period which includes the date
the positive blood specimen
the positive blood specimen was
was collected, the 3 calendar
collected, the 3 calendar days before and
days before and the 3 calendar
the 3 calendar days after.
days after.
*Common commensal: diphtheroids [Corynebacterium spp. Not C. 3diphtheria], Bacillus spp. {not B. anthracis], Propionibacterium spp., coagulase-negative staphylococci [including S. epidermidis], viridans group streptococci, Aerococcus spp., and Micrococcus spp.) See complete list of common commensals under Supporting Materials section of BSI protocol ( http://www.cdc.gov/nhsn/acute-care-hospital/clabsi/index.html )
For any event meeting LCBI criteria above, determine whether event is an MBI-LCBI using criteria below.
Patient meets at least one of the following: Allogeneic hematopoietic stem cell transplant recipient within the past year with one of the following documented
during the same hospitalization as positive blood specimen: Grade III or IV gastrointestinal graft vs. host disease (GI-GVHD) and/or ≥1 liter diarrhea in a 24-hour period (or ≥20 mL/kg in a 24-hour period for patients <18 years of age) with
Prevotella spp., Veillonella spp., Enterobacteriaceae*,
*Partial list of MBI-LCBI eligible Enterobacteraciae genera: Citrobacter, Enterobacter, Escherichia, Klebsiella, Proteus, Providencia, Serratia, Shigella, Yersinia
A complete list of MBI-LCBI is available under the supporting material section of BSI protocol ( http://www.cdc.gov/nhsn/acute-care- hospital/clabsi/index.html )