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Despite Progress, three-quarters of a million infections threaten hospital patients each year

Categories: Antimicrobial Resistance, BSIs, CAUTI, CLABSI, Clostridium difficile, Healthcare-associated infections, Long Term Care (LTC), NHSN, State HAI Prevention

National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014

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.

CDC launches new website for preventing infections in long term care

Categories: Healthcare-associated infections, Long Term Care (LTC)

Nimalie Stone, MD

Nimalie Stone, MD

Author: Nimalie Stone, MD
Medical Epidemiologist
CDC’s Division of Healthcare Quality Promotion

The past few years have brought heightened awareness of the important role of infection prevention programs and activities in long-term care settings, including nursing homes and assisted living. Navigating all the information available on infection prevention in healthcare facilities can be overwhelming, and it can be particularly difficult to locate available resources that are specific to long-term care settings. To address this need, my CDC colleagues and I have worked to redesign and expand our web-based tools and resources for this important healthcare setting.

Today, we are excited to unveil CDC’s Infection prevention website for long-term care facilities! This site organizes existing infection prevention guidance and resources into sections for clinical staff, infection prevention coordinators, and residents. Facilities can also directly access the new infection tracking system for long-term care facilities in CDC’s National Healthcare Safety Network, and the innovative infection prevention tools and resources developed as part of the partnership between CDC and the Advancing Excellence in America’s Nursing Homes Campaign (AE). AE is a well-established quality improvement campaign, supported by national nursing home partners. The partnership between CDC and AE grew tremendously through our joint effort to develop and launch the Infection goal to prevent C. difficile infections in nursing home residents. By cross-promoting the AE infection resources on the CDC website, we hope to bring a new audience to the AE campaign while also exposing the campaign’s participants to even more CDC tools to support their local infection prevention activities.

One Hospital, One Heart, Let’s Get Together to Control VRE (Vancomycin-Resistant Enterococci)

Categories: Healthcare-associated infections, Long Term Care (LTC)

Bruce Y. Lee, MD, MBA

Bruce Y. Lee, MD, MBA

 
Authors – Bruce Y. Lee, MD, MBA

Associate Professor of International Health and Director of Operations Research
International Vaccine Access Center
Johns Hopkins Bloomberg School of Public Health

 
Think when another hospital in a region has a vancomycin-resistant enterococci (VRE) bacteria problem that it’s their problem and not your hospital’s problem? Think again. As demonstrated by our recent computer modeling study published in the American Journal of Infection Control, a VRE problem in one hospital can soon spread to hospitals throughout a county. This is because hospitals are connected to each other by patient sharing: a patient colonized with VRE leaving one hospital can readily end up in another hospital, either by direct transfer or after an intervening stay in the community.
 
Therefore, (if it hasn’t already done so), VRE may be coming soon to a hospital near you. And the VRE movie can be a horror show for healthcare workers and patients. The VRE bacteria are resistant to vancomycin, a dear old last line of defense in our antibiotic arsenal. When vancomycin doesn’t work, few alternatives are left to treat life-threatening infections.
 
To study the spread of VRE, our computer modeling “Avengers” team used RHEA (the Regional Healthcare Ecosystem Analyst, a software platform developed by us) to build a computer virtual representation of all the hospitals in Orange County, California, and their patients and surrounding community (instead of SimCity, think SimHospitals-in-Orange-County). This “virtual laboratory” allowed us to perform experiments that you should not do in real life, such as infecting different virtual patients with VRE and seeing how soon VRE appeared or increased in other hospitals or demonstrating how hospitals making no attempt to control VRE could “free-ride” on the efforts of hospitals that do.
 
These experiments demonstrated that, in the spirit of Bob Marley’s song “One Love”, we are in fact “one hospital, “one heart”, so let’s work together to control VRE. The question is, how can we best make this happen?

When Antibiotics Lead to Deadly Diarrhea…

Categories: Antibiotic use, Long Term Care (LTC)

Matthew Wayne MD, CMD

Matthew Wayne MD, CMD

Author – Matthew Wayne MD, CMD,
Chief Medical Officer for CommuniCare Family of Companies,
President of the American Medical Directors Association (AMDA)

So, you’ve recently taken antibiotics and you’ve now developed a case of disturbing diarrhea. Should you be concerned? Maybe so…
Antibiotic-associated diarrhea refers to diarrhea that develops in a person who is taking or recently took antibiotics. One of the most serious causes of antibiotic-associated diarrhea is Clostridium difficile (C. difficile) infection – a major cause of acute diarrhea in long-term care facilities. Not only does C. difficile cause discomfort, it actually results in nearly 14,000 deaths every year—90% of these involve people aged 65 or older. People who have recently taken antibiotics are at greatest risk for C. difficile, which is yet another reason we need to use these medications carefully in our nursing homes and long-term care facilities.

Addressing Antibiotic Use in Nursing Homes – It Starts with a Conversation

Categories: Antibiotic use, Long Term Care (LTC)

Nimalie Stone, MD

Nimalie Stone, MD

Author – Nimalie Stone MD,
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention.

As you have read in the posts from our academic and clinical partners, much work needs to be done to impact the systems and behaviors driving antibiotic use in the nursing home setting.

We believe many of the principles of antibiotic stewardship we apply in hospitals would also hold true in other healthcare settings. However, we do not have the same levels of clinical experience and research evidence to implement this activity in our nation’s nursing homes. As an important first step in developing a strategy to promote improved antibiotic use in these healthcare facilities, CDC has reached out to key partners across the nursing home industry to get their input and advice. In fact, today CDC is having face-to-face conversations with these industry stakeholders to discuss and outline next steps towards improved antibiotic use in nursing homes.

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