Categories: CAUTI, Clostridium difficile, Healthcare-associated infections
September 2nd, 2014 12:31 pm ET -
CDC's Safe Healthcare Blog
Wendy Kaler, CLS, MPH,CIC
Guest Author: Wendy Kaler, MPH, CIC
Dignity Health Clinical Lead for CAUTI Prevention
At Dignity Health, our goal is to reduce the rate of hospital-acquired infections (HAI) by 40 percent and readmissions by 20 percent before 2015, and we are well on our way. We have introduced specific evidence-based practices and bedside intervention activities to evaluate full adoption of safe preventive practices and assure coordination of care at the bedside with clinicians, including physicians. When I am provided the opportunity to share my experiences with Dignity Health’s “No Harm Campaign” to prevent catheter-associated urinary tract infection (CAUTI), I am often asked “why is it so difficult to get Foleys discontinued?”
Weighing the Benefits and Risks of Using a Foley
During training, physicians and nurses are made aware of the advantages of indwelling urinary catheters indwelling urinary catheters, but oftentimes the instructors do not focus on the associated risks of these devices. With competing priorities and time constraints, health care providers do not prioritize indwelling urinary catheters as a device that should be assessed daily for need, especially in the critical care units. Historically, the intensive care unit (ICU) staff believed that all critical care unit patients need a Foley. Lack of good alternatives available to provide bladder management and output measurement have contributed to this practice. Bedside nurses are ultimately managing the Foley and the advantages for them are understandable, including reducing the amount of time they must spend managing the bladders of their patients and keeping their patients skin dry. However, bedside nurses need to be aware that the risks to the patient are greater than the advantage to themselves. For example, if a patient develops a UTI and is treated with antibiotics, they are at an increased risk to develop multi-drug resistant organisms or C. difficile infection.
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Categories: Antimicrobial Resistance, BSIs, CAUTI, CLABSI, Clostridium difficile, Healthcare-associated infections, Long Term Care (LTC), NHSN, State HAI Prevention
March 26th, 2014 2:47 pm ET -
National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014
Despite Progress, three-quarters of a million infections threaten hospital patients each year
National and state data detail threat of healthcare-associated infections and opportunities for further improvements.
CDC released two reports today – one, a New England Journal of Medicine (NEJM) article detailing national healthcare-associated infection estimates, and the other an annual report on national and state-specific progress toward U.S. Health and Human Services HAI prevention goals. Together, the reports show that progress has been made in the effort to eliminate infections that commonly threaten hospital patients, but more work is needed to improve patient safety.
The NEJM article updates the burden numbers for healthcare-associated infections in hospitals. On any given day, 1 of every 25 patients had 1 or more infections related to their hospital stay. That means about 722,000 infections a year related to medical care. One of every 9 patients who gets an infection will die during their hospitalization.
This article sounds the alarm about threats we need to address now. It tells us that lung infections, gut infections, surgical infections and infection from urinary catheters are harming the most patients.
Some of the top pathogens attacking patients are:
- C. difficile, or deadly diarrhea,
- Staph, including the drug-resistant type known as MRSA,
- a family of germs known as Enterobacteriaceae, that includes CRE the “nightmare bacteria,”
The second report, CDC’s National and State Healthcare-associated Infection Progress Report, includes national and state-by-state summaries of infection types that are commonly required to be reported to CDC. The Progress Report looked at data submitted to CDC’s National Healthcare Safety Network (NHSN), the nation’s healthcare-associated infection tracking system. On the national level, the report found a:
- 44 percent decrease in central line-associated bloodstream infections between 2008 and 2012
- 20 percent decrease in infections related to the 10 surgical procedures tracked in the report between 2008 and 2012
- 4 percent decrease in hospital-onset MRSA bloodstream infections between 2011 and 2012
- 2 percent decrease in hospital-onset C. difficile infections between 2011 and 2012
- 3 percent increase in catheter-associated urinary tract infections
At the federal and state levels, CDC uses this information to find facilities that need help and target resources where they are most needed.
To access both reports and to see the updated healthcare-associated infection data, see CDC’s website: www.cdc.gov/hai.
Watch a new video on Healthcare-Associated Infections.
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Categories: Clostridium difficile, Healthcare-associated infections
March 7th, 2014 9:20 am ET -
CDC's Safe Healthcare Blog
Peggy Lillis was the mother of two and a Brooklyn kindergarten teacher. Peggy lost her battle to C. difficile infection in 2010. She had only been ill for 6 days. Learn more about Peggy’s story: http://www.peggyfoundation.org/
Author: Christian John Lillis
My mother loved children. Me and my brother Liam, her 12 godchildren, and the 24 children she taught each year in her kindergarten class. We lost Mom at just 56 years old to a Clostridium difficile infection in April 2010. In response to her death, we started the Peggy Lillis Foundation to raise C. diff awareness.
That is why we are both distressed and pleased by the Centers for Disease Control and Prevention’s new paper on C. diff infections in children. Distressed that so many children are suffering but pleased that the paper explodes a piece of C. diff mythology that persists in our healthcare system, where even some physicians cling to a dangerous notion that children don’t get C. diff.
The CDC finding that 17,000 children contract the disease each year, most outside of healthcare settings, is a call to action for healthcare providers. Clinicians should consider whether symptoms such as fever, loss of appetite, cramping, and painful diarrhea might be indications of C. diff. When prescribing antibiotics to kids, they should ask themselves whether the drug is absolutely necessary, since antibiotic exposure is a key risk factor for C. diff.
This report also alerts parents to ask doctors whether symptoms they can plainly see are severe and out of the ordinary might be signs of a C. diff infection, especially if their child has recently taken an antibiotic. In the presence of such symptoms, especially when initial treatments don’t work, parents should ask about a stool test.
In 2013, the CDC declared C. diff. an "urgent" public-health threat, placing it first on the list of critical dangers to Americans. But many reports of C. diff focus on adults and seniors in long-term care settings, leading to ignorance of its risks to younger patients.
Angela G., a Brooklyn mother, found this out the hard way when her kids were five and two. Spotting symptoms like fever and diarrhea, she took them to a pediatrician who insisted they had a stomach flu. After escalating symptoms, repeated visits, and finally a trip to the emergency room, a test resulted in the proper diagnosis: C. diff.
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Categories: Antimicrobial Resistance, Clostridium difficile, Healthcare-associated infections
October 25th, 2013 9:01 am ET -
CDC's Safe Healthcare Blog
Steven Schmitt, MD, FIDSA
Guest Author – Steven Schmitt, MD, FIDSA
Chair of the Infectious Diseases Society America’s Clinical Affairs Committee and infectious diseases physician at Cleveland Clinic
We’re all well aware that infection is a major problem among hospitalized patients, sometimes arriving with infection as a reason for admission and sometimes developing infection in the hospital. In either case, infection is among the top causes of death in the hospital and hospital-acquired infections affect one in 20 patients. Many of these infections are resistant to antibiotics, making them extremely difficult to treat. So what is the answer? Get patients the type of care they deserve – in this case, treatment provided by physicians who are experts in infectious diseases. A recent study published in Clinical Infectious Diseases– based on Medicare data from nearly 130,000 hospitalized patient cases – provides strong evidence that infectious diseases expertise is invaluable.
To quantify the value of ID physicians, we studied the records of patients who had at least one of 11 common types of infections, including Clostridium difficile, which the CDC recently named as one of the top three urgent threats in its landmark antibiotic resistance report. Other infections included: bacteremia, central line associated bloodstream infections (CLABSI), bacterial endocarditis, HIV/opportunistic infections, meningitis, osteomyelitis, prosthetic joint infections, septic arthritis, septic shock and vascular device infections. Matching patient characteristics, we compared the outcomes of those who had seen an ID physician and those who had not.
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Categories: Antimicrobial Resistance, Clostridium difficile
March 6th, 2012 2:08 pm ET -
CDC Vital Signs. Learn vital information about stopping C. difficile infections. Read CDC Vital Signs
Author – Clifford McDonald MD
Prevention and Response Branch Chief
CDC’s Division of Healthcare Quality Promotion
Looking back now, it is like a movie playing out in my mind. We were at the 2004 IDSA conference in Boston, and my colleagues from the CDC lab, Dr. Dale Gerding’s laboratory, other scientific collaborators, and I were presenting on a new strain of Clostridium difficile called NAP1. I’m not sure everyone understood the implications. Some realized NAP1 could be big; others felt that C. diff wasn’t that big of a deal. For me, it was like seeing a train coming, and you can’t get off the tracks.
Clostridium difficile infections have been an important part of my career. Upon wrapping up the SARS investigations for CDC in Toronto, I turned my attention to C. difficile, as I sensed there was something going on that needed further investigation. Now, here we are 8 years later, and NAP1, which causes severe infection, is still a major issue in the United States.
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