The accuracy of fully-automated algorithms for the surveillance of central venous catheter-related bloodstream infection in hospitalised patients

Table 2 Performance characteristics two rule-based algorithms for central venous catheter-related bloodstream infection according to ECDC definition

All CVC-BSI	TP	FP	FN	TN	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	AUROC (95%CI)	Kappa (95%CI)
Validation dataset with admissions with at least one positive BCx (potential CVC-BSI-episodes^a n = 4326)
Algorithm 1^b	44	3	7	4272	0.863 (0.743–0.932)	0.999 (0.998–1.000)	0.936 (0.828–0.978)	0.998 (0.997–0.999)	0.931 (0.883–0.979)	0.897 (0.867–0.927)
Algorithm 2^c	45	4	6	4271	0.882 (0.766–0.945)	0.999 (0.998–1.000)	0.918 (0.808–0.968)	0.999 (0.997–0.999)	0.941 (0.896–0.985)	0.899 (0.869–0.929)
Extrapolated results^d for validation period cohort (potential CVC-BSI-episodes^a n = 181,354)
Algorithm 1^b	–	–	–	–	0.861 (0.764–0.959)	1.000 (0.999–1.000)	0.935 (0.850–1.000)	1.000 (0.999–1.000)	0.931 (0.910–0.951)	0.897 (0.892–0.901)
Algorithm 2^c	–	–	–	–	0.880 (0.783–0.959)	1.000 (0.999–1.000)	0.918 (0.833–0.981)	1.000 (0.999–1.000)	0.940 (0.921–0.960)	0.899 (0.894–0.903)

HA CVC-BSI	TP	FP	FN	TN	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	AUROC (95%CI)	Kappa (95%CI)
Validation dataset with admissions with at least one positive BCx (potential CVC-BSI-episodes^a n = 4326)
Algorithm 1^b	25	1	7	4293	0.781 (0.612–0.890)	1.000 (0.999–1.000)	0.962 (0.811–0.993)	0.998 (0.997–0.999)	0.891 (0.818–0.963)	0.861 (0.832–0.891)
Algorithm 2^c	26	1	6	4293	0.813 (0.647–0.911)	1.000 (0.999–1.000)	0.963 (0.817–0.993)	0.999 (0.997–0.999)	0.906 (0.837–0.975)	0.881 (0.851–0.910)
Extrapolated results^d for validation period cohort (potential CVC-BSI-episodes^a n = 181,354)
Algorithm 1^b	–	–	–	–	0.784 (0.629–0.910)	1.000 (0.999–1.000)	0.956 (0.868–1.000)	1.000 (0.999–1.000)	0.892 (0.861–0.924)	0.861 (0.857–0.866)
Algorithm 2^c	–	–	–	–	0.814 (0.659–0.940)	1.000 (0.999–1.000)	0.958 (0.873–1.000)	1.000 (0.999–1.000)	0.907 (0.878–0.937)	0.880 (0.876–0.885)

AUROC: area under the receiver operating characteristic curve; BCx: blood culture; CVC-BSI: central venous catheter-related bloodstream infection; ECDC: European Centre for Disease Prevention and Control; FN: false negative; FP: false positive; HA: healthcare-associated; NPV: negative predictive value; PPV: positive predictive value; TN: true negative; TP: true positive
^aCVC-BSI-episode: all performed BCx were regarded as potential CVC-BSI-episodes during an admission, and admissions with no BCx counted as one potential CVC-BSI-episode
^bAlgorithm 1: Relevant microbiological findings in BCx and CVC cultures combined with the presence of BSI symptoms
^cAlgorithm 2: Only relevant microbiological findings in BCx and CVC cultures
^dThe extrapolated results of the algorithms from the validation dataset to the validation period cohort (2018–2019) were based on the sampling proportion of potential CVC-BSI-episodes from the three different groups: 1) admissions with at least one positive BCx; 2) admissions with only negative BCx and; 3) admissions without a BCx

ISSN: 2047-2994