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CDC reports: HAI rates improving, but much work remains

Sunday March 30, 2014
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On any given day, approximately 1 in 25 U.S. patients has at least one infection contracted during hospital care, adding up to about 722,000 infections in 2011, according to the CDC’s updated estimate of healthcare-associated infections.

The agency released two reports: a New England Journal of Medicine article detailing 2011 national HAI estimates from a survey of hospitals in 10 states and a 2012 annual report on national and state-specific progress toward prevention goals established by the Department of Health and Human Services.

Together, the reports show progress has been made in the effort to eliminate infections that commonly threaten hospital patients, but more work is needed to improve patient safety, according to a news release.

“Although there has been some progress, today and every day, more than 200 Americans with healthcare-associated infections will die during their hospital stay,” CDC Director Tom Frieden, MD, MPH, said in the news release.

“The most advanced medical care won’t work if clinicians don’t prevent infections through basic things such as regular hand hygiene. Healthcare workers want the best for their patients; following standard infection control practices every time will help ensure their patients’ safety.”

The CDC’s “Multistate Point-Prevalence Survey of Health Care-Associated Infections,” published in the March 26 issue of the New England Journal of Medicine, used 2011 data from 183 U.S. hospitals to estimate the burden of a wide range of infections in hospital patients.

That year, about 721,800 infections occurred in 648,000 hospital patients. About 75,000 patients with HAIs died during their hospitalizations. The most common HAIs were pneumonia (22%), surgical site infections (22%), gastrointestinal infections (17%), urinary tract infections (13%) and bloodstream infections (10%).

The most common germs causing healthcare-associated infections were C. difficile (12%), Staphylococcus aureus, including MRSA (11%), Klebsiella (10%), E. coli (9%), Enterococcus (9%) and Pseudomonas (7%). Klebsiella and E. coli are members of the Enterobacteriaceae bacteria family, which has become increasingly resistant to last-resort antibiotics known as carbapenems.

Study: www.nejm.org/doi/full/10.1056/NEJMoa1306801

Tracking national progress

The second report, the CDC’s national and state "Healthcare-associated Infection Progress Report,” includes a subset of infection types that commonly are required to be reported to CDC.

On the national level, the report found a 44% decrease in central line-associated bloodstream infections between 2008 and 2012; a 20% decrease in infections related to the 10 surgical procedures tracked in the report between 2008 and 2012; a 4% decrease in hospital-onset MRSA between 2011 and 2012; and a 2% decrease in hospital-onset C. difficile infections between 2011 and 2012.

“Our nation is making progress in preventing healthcare-associated infections through three main mechanisms: financial incentives to improve quality, performance measures and public reporting to improve transparency, and the spreading and scaling of effective interventions,” Patrick Conway, MD, deputy administrator for Innovation and Quality at the Centers for Medicare & Medicaid Services and CMS chief medical officer, said in the news release. “This progress represents thousands of lives saved, prevented patient harm and the associated reduction in costs across our nation.”

State data

The Progress Report included data submitted to the CDC’s National Healthcare Safety Network, the nation’s healthcare-associated infection tracking system, which is used by more than 12,600 healthcare facilities across all 50 states, Washington, D.C., and Puerto Rico. Not all states reported or had enough data to calculate valid infection information on every infection in this report. The number of infections reported was compared to a national baseline.

In the report, none of the 50 states, D.C. or Puerto Rico performed better than the national average on all four infection types tracked by state (CLABSI, CAUTI and infections after colon surgery and abdominal hysterectomy). Sixteen states performed better than the nation on two of the infections and 16 performed worse on two infections.

Report: www.cdc.gov/hai/progress-report/index.html


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