Hospitals Steadily Reducing Most Inpatient Infection Rates

Hospitals throughout the United States have made significant progress in reducing healthcare-associated infections and are on track to meet goals set in 2008 as part of the National Action Plan to Prevent Healthcare-Associated Acquired Infections, according to a report published online February 11 by the Centers for Disease Control and Prevention (CDC).

The CDC analysis found that central line–associated bloodstream infections have decreased by 41% (toward a goal of a 50% decrease) and surgical site infections have decreased by 17% (toward a goal of 25%). Rates for both infection sites improved from 2008 to 2010 and continued to improve from 2010 to 2011.

Catheter-associated urinary tract infections (UTIs) had decreased 7% by 2010 (toward a goal of 25%) but have not decreased further since then, particularly in critical care locations. Catheter-associated UTIs in patients in the intensive care unit are a particular concern because of the associated increased need for antibiotics and because of the risk for other infections, including the potentially deadly Clostridium difficile.

The CDC authors, led by Paul J. Malpiede, MPH, from the CDC's Division of Healthcare Quality Promotion, suggest that the lack of progress on catheter-associated UTIs might be a result of "lack of substantial progress in critical care areas, an inability to substantially decrease catheter days in critical care areas (as can be done more easily in wards), or both of these factors." However, they also point out that Michigan hospitals have achieved a 25% reduction in catheter-associated UTIs using a device day rate–based standardized infection ratio and prevention initiatives.

The CDC used data submitted to the National Healthcare Safety Network, the CDC's premiere infection tracking system, which receives data from more than 11,500 healthcare facilities across all 50 states, the District of Columbia, and Puerto Rico. The number of infections reported was compared with data from 2010 as well as with a national baseline.

"The significant decrease in central line and surgical site infections means that thousands of patients avoid prolonged hospitalizations and the risk of dying in the hospital. Providers, working with CDC and CMS, are fulfilling Medicare's quality measurement reporting requirements for hospital infections and demonstrating that, together, we can dramatically improve the safety and quality of care for patients," Patrick Conway, MD, chief medical officer of the Center for Medicare & Medicaid Services (CMS), said in a news release.

CDC Director Tom Frieden, MD, MPH, also noted in the release that, "Reductions in some of the deadliest health care-associated infections are encouraging, especially when you consider the costs to both patients and the health care system. This report also suggests that hospitals need to increase their efforts to track these infections and implement control strategies that we know work."

The authors have disclosed no relevant financial relationships.

"2011 National and State Healthcare-Associated Infection Standardized Infection Ratio Report." CDC. Published online February 11, 2013. Full text