US Hospitals Improve Infection Control, More Work Ahead: CDC

Megan Brooks

January 14, 2015

US acute-care hospitals are making progress cutting healthcare-associated infections, including methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C difficile) infections, but continued improvements are needed, US health officials said today.

The Centers for Disease Control and Prevention's (CDC's) National and State Healthcare-Associated Infections (HAI) Progress Report shows significant reductions at the national level in 2013 for nearly all infections.

"Despite this progress…more action is needed at every level of public health and health care to improve patient safety and eliminate infections that commonly threaten hospital patients," the authors of the report write.

On the national level, there was a 46% decrease in central line-associated bloodstream infections (CLABSI) between 2008 and 2013.

During the same period, there was a 19% decrease in surgical site infections (SSIs) related to 10 select procedures tracked in the report between 2008 and 2013. For example, SSIs in abdominal hysterectomy fell 14%, while colon surgery SSIs dropped 8%.

The progress report also shows an 8% decrease in hospital-onset MRSA bacteremia and a 10% drop in hospital-onset C difficile infections between 2011 and 2013.

There was a 6% increase in catheter-associated urinary tract infections (CAUTI) between 2009 and 2013, although early indications from 2014 suggest that these infections have started to decrease, the report notes.

"Real Progress"

"Hospitals have made real progress to reduce some types of healthcare-associated infections — it can be done," CDC Director Tom Frieden, MD, MPH, said in a news release. "The key is for every hospital to have rigorous infection control programs to protect patients and healthcare workers, and for health care facilities and others to work together to reduce the many types of infections that haven't decreased enough," Dr Frieden said.

On the state level, 26 states performed better than the nation on at least two of the six infection types tracked by state (CLABSI, CAUTI, MRSA, C difficile, and SSI after colon surgery and abdominal hysterectomy).

Sixteen states performed better than the nation on three or more infections, including six states that performed better on four infections. Nineteen states performed worse than the nation on two infections, with eight states performing worse on at least three infections, according to the report.

Data for the report come from the CDC's National Healthcare Safety Network (NHSN), which tracks healthcare-associated infections. More than 13,000 hospitals and other healthcare facilities provide data to NHSN.

"This report shows that although significant progress was made in some infection types, there is much more work to be done. On any given day, approximately one in 25 US patients has at least one infection contracted during the course of their hospital care," the report notes.

"Healthcare-associated infection data give healthcare facilities and public health agencies knowledge to design, implement and evaluate HAI prevention efforts," Patrick Conway, chief medical officer of the Centers for Medicare & Medicaid Services, said in the CDC news release. "Medicare's quality measurement reporting requires hospitals to share this information with the CDC, demonstrating that, together, we can dramatically improve the safety and quality of care for patients."

"Successful programs such as CUSP [Comprehensive Unit-based Safety Program] demonstrate that combining sound HAI data with effective interventions to prevent these infections can have enormous impact," added Richard Kronick, PhD, director of the Agency for Healthcare Research and Quality.

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