Dialysis Surveillance Network (DSN)

About the Dialysis Surveillance Network (DSN)

The Dialysis Surveillance Network (DSN), a voluntary national surveillance system monitoring bloodstream and vascular infections, was initiated by CDC in August 1999. Both adult and pediatric dialysis centers treating outpatients are invited to participate.

Bacterial infections, especially those involving the vascular access site, cause considerable morbidity and mortality in hemodialysis patients. Due to frequent hospitalizations and receipt of antimicrobials, these patients are at high risk for infection or colonization with antimicrobial-resistant bacteria. However, there are few recent studies of bacterial infections in hemodialysis patients, and previously there were no standardized surveillance methods.

The purposes of the DSN are as follows:

• To provide a method for individual hemodialysis centers to record and track rates of vascular access infections, other bacterial infections, and intravenous antimicrobial starts.
• To provide rates for comparisons among various dialysis centers (benchmarking).
• To use these data to motivate practice changes and to prevent infections, especially those caused by antimicrobial resistant organisms.

Participating centers may enter data on paper forms provided by CDC and receive a data analysis report every quarter. Alternatively, they may use our Internet-based system for data entry and analysis and generate and print reports whenever desired. There are no fees or financial remuneration for participating in this system. While summary data are released, the data from individual centers are confidential and cannot be released to anyone other than the dialysis center reporting it.

Unique features of the DSN include:

• User-friendly methods simplify reporting.
• Data collectors record the presence or absence of criteria for infections, not the infections themselves.
• A computer algorithm determines whether the infection case definitions are met.
• The data collector does not have to memorize case definitions.
• The frequency of blood culturing, a factor that may influence reported infection rates, is determined.
• Several different rates are reported to better characterize the situation at any given center.

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