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Selected Category: State HAI Prevention

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.

What Happens in the Outpatient Clinic Doesn’t Always Stay in the Outpatient Clinic: Lessons from a Regional Outbreak of Adenovirus-associated Epidemic Keratoconjunctivitis (EKC)

Categories: Healthcare-associated infections, Outpatient Care, State HAI Prevention

Andrew Wiese, MPH

Andrew Wiese, MPH

Author – Andrew Wiese, MPH
Applied Epidemiology Fellow
Tennessee Department of Health
CDC, Council of State and Territorial Epidemiologists (CSTE)

This week’s Morbidity and Mortality Weekly Report (MMWR) includes a description of six separate outbreaks of Adenovirus-associated epidemic keratoconjunctivitis (EKC) in four different states. These outbreaks were mainly associated with outpatient eye care.

Last August, as a new CDC/CSTE Applied Epidemiology fellow in the Tennessee Department of Health (TDH), I experienced firsthand an outbreak that was similar to those described in the MMWR. We were contacted by a concerned patient who experienced severe conjunctivitis after receiving care at a local ophthalmology clinic and was aware of similarly affected patients.  I was asked to help lead the investigation.

Communication with the clinic identified gaps related to cohorting of suspected cases, procedures for disinfection of equipment and surfaces, and the policy for the appropriate length of time ill staff should be kept from patient contact.  Our TDH team then guided implementation of appropriate infection control practices to prevent further transmission.  While our investigation identified ninety cases of EKC at the clinic, only a single case from the clinic occurred after the health department’s intervention.

“You Could Have Heard a Pin Drop.” Kent Hospital Renews Vigilance on Injection Safety Rules

Categories: Healthcare-associated infections, Injection Safety, State HAI Prevention

Peter Graves MD

Peter Graves MD

Guest Author – Peter Graves, MD
Chairman, Department of Emergency Medicine
Academic Faculty, Kent Hospital Emergency Medicine Residency Program
Kent Hospital
Warwick, RI

One of the great “truisms” of Life is that we often don’t know—what we don’t know. In other words, we can’t imagine the scope of a problem if we are under the assumption that it doesn’t even exist.

No provider goes to the hospital or office with the intent of harming patients. So I was shocked to learn that the Centers for Disease Control and Prevention has tracked over 40 outbreaks of infectious disease caused by unsafe injection practices including hepatitis B (HBV), hepatitis C (HCV) and bacterial infections in the past 10 years in the United States. It is fundamentally unacceptable that these outbreaks were because healthcare providers failed to follow Standard Precautions when preparing an injection. Those lapses in basic infection control include reusing needles and syringes from patient to patient or misusing single-dose and multi-dose vials. This boggles the minds of many practitioners who may feel they are following correct procedures—when in fact they might not be doing so at all.

California Initiative Promotes Appropriate Use of Antimicrobials in Healthcare Facilities

Categories: Antimicrobial Resistance, State HAI Prevention

Dr. Trivedi

Dr. Trivedi

Author – Dr. Trivedi,
California Antimicrobial Stewardship Program Initiative,
California Department of Public Health.

In February 2010, the California Department of Public Health (CDPH) launched the country’s first statewide initiative to promote optimization of antimicrobials in healthcare facilities. In less than two years, the cutting-edge California Antimicrobial Stewardship Program (ASP) Initiative is helping California healthcare facilities establish programs to improve patient safety and quality.

The Healthcare Associated Infections (HAI) Program of CDPH developed the statewide California Antimicrobial Stewardship Program (ASP) Initiative as the result of a statutory mandate. California Senate Bill 739 required CDPH to ensure that each general acute care hospital assemble a quality improvement committee to oversee the results of a process for evaluating the judicious use of antibiotics. While hospitals were aware of this mandate, they were left to implement programs on their own. The Initiative offers California healthcare facilities a valuable resource for antimicrobial use education, guidance and consultation.

NY State collaborative – a groundbreaking Antimicrobial Stewardship Project for hospitals and long-term care

Categories: Antimicrobial Resistance, Healthcare-associated infections, State HAI Prevention

David P. Calfee, MD, MS

David P. Calfee, MD, MS

Author – David P. Calfee, MD, MS
Associate Professor of Medicine and Public Health at Weill Cornell Medical College,
Chief Hospital Epidemiologist at New York-Presbyterian Hospital/Weill Cornell in New York City

The GNYHA, UHF, and NYSDOH Antimicrobial Stewardship Project

While most discussions of antibiotic resistance and improving antibiotic prescribing practices (“antimicrobial stewardship”) focus on hospitals, antibiotic resistance and inappropriate antibiotic use are also prevalent in long-term care facilities (LTCFs). In fact, antibiotic resistance rates in LTCFs are often higher than in hospitals. Consequently, in 2009 the Greater New York Hospital Association, United Hospital Fund, and New York State Department of Health launched the Antimicrobial Stewardship Project.

The project pursued effective strategies for antimicrobial stewardship programs in LTCFs to demonstrate that beneficial activities could be performed without significant investment in new resources, and to demonstrate the value of hospital-LTCF partnerships in antimicrobial stewardship activities. Another goal was to develop tools and materials to assist project participants and other healthcare facilities to develop and manage their antimicrobial stewardship programs.

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