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U.S. Hospitals Making Progress in Infection Control, CDC Says

But continued improvements needed

Progress has been made in the effort to eliminate infections that commonly threaten hospital patients, including a 46% decrease in central line-associated bloodstream infections (CLABSI) between 2008 and 2013, according to a new report from the Centers for Disease Control and Prevention (CDC). However, additional work is needed to continue to improve patient safety.

The CDC’s National and State Healthcare-Associated Infections Progress Report is a snapshot of how each state and the country are doing in eliminating six infection types that hospitals are required to report to the CDC. For the first time, this year’s report includes state-specific data about hospital laboratory-identified methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile infections (“deadly diarrhea”).

The annual report expands on and provides an update to previous reports detailing progress toward the goal of eliminating health care-associated infections (HAIs). The report summarizes data submitted to the CDC’s National Healthcare Safety Network (NHSN), the nation’s health care-associated infection tracking system, which is used by more than 14,500 health care facilities in all 50 states, Washington, D.C., and Puerto Rico.

HAIs are a major, yet often preventable, threat to patient safety. On any given day, approximately one in 25 hospitalized patients in the U.S. has at least one infection contracted during the course of his or her hospital care, demonstrating the need for improved infection control in U.S. health care facilities, the CDC says.

The new report focuses on national and state progress in reducing infections occurring within acute-care hospitals. Although not covered by the report, most C. difficile and MRSA infections develop in the community or are diagnosed in health care settings other than hospitals. Other recent reports on infections caused by pathogens such as C. difficile and MRSA suggest that infections in hospitalized patients account for only about one-third of all health care-associated infections.

On the national level, the new report found a:

  • 46% decrease in central line-associated bloodstream infections (CLABSIs) between 2008 and 2013. CLABSIs occur when a tube is placed in a large vein and is either not put in correctly or is not kept clean, becoming a proverbial highway for germs to enter the body and cause deadly blood infections.
  • 19% decrease in surgical-site infections (SSIs) related to the 10 select procedures tracked in the report between 2008 and 2013. When germs get into the surgical wound, patients can develop an SSI involving the skin, organs, or implanted material.
  • 6% increase in catheter-associated urinary-tract infections (CAUTIs) since 2009, although initial data from 2014 appear to indicate that these infections have started to decrease. When a urinary catheter is not put in correctly, is not kept clean, or is left in a patient for too long, germs can travel through the catheter and infect the bladder and kidneys.
  • 8% decrease in MRSA bloodstream infections between 2011 and 2013.

Research shows that when health care facilities, care teams, and individual doctors and nurses are aware of infection-control problems and take specific steps to prevent them, rates of targeted HAIs can decrease dramatically, according to the CDC.

The report provides data that can be used by hospitals to target improvements in patient safety in their facilities. For example, together with professional partners, the CDC increased attention to the prevention of CAUTIs, resulting in a reversal of the recent increase seen in these infections. The CDC is also working to use HAI data to help identify specific hospitals and wards that can benefit from additional infection-control expertise.

Sources: CDC; January 14, 2015; and HAI Progress Report; January 2015.

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