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Where Innovation Meets Prevention: HAI Prevention Research

Posted on by CDC's Safe Healthcare Blog
John A. Jernigan, MD, MS
John A. Jernigan, MD, MS

Author – John Jernigan, M.D.CDC’s Division of Healthcare Quality Promotion

In recent weeks, we have witnessed some encouraging progress in preventing healthcare associated MRSA infections in the US, mainly through better implementation of existing prevention recommendations. While this is certainly a cause for celebration, there is still a long way to go.

This is where prevention research comes in. We need to increase our arsenal of weapons if we hope to get close to the goal of eliminating HAIs. There could be new and effective strategies out there remaining to be discovered. These will remain hidden to us unless we explore novel approaches to HAI prevention, and translate the findings into evidence-based guidelines.

That’s why CDC engages in and funds HAI prevention research. CDC’s Prevention Epicenter Program supports efforts to develop and test innovative approaches to reducing infections in healthcare settings. One example of how CDC’s investment in HAI prevention research helped develop a promising new strategy is the use of a skin antiseptic in routine bathing of patients to prevent HAIs. CDC-funded investigators at Cook County Hospital and Rush University Medical School hypothesized that bathing patients daily with a skin antiseptic would decrease the burden of the germs on the patient’s skin, and indirectly decrease contamination of the environment of healthcare personnel (HCP) hands, and thus decrease transmission of pathogens.

CDC-funded studies went on to show that daily chlorhexadine (CHG) bathing can significantly reduce contamination of patient’s skin, the environment, and HCP hands, with organisms such as MRSA and VRE. Reductions in spread of MRSA and VRE have been documented using this strategy, and there at least two separate studies showing reduction in bloodstream infections. It is also encouraging that the experience to date suggests this strategy is simple for hospitals to implement and is well tolerated by patients. The CDC Prevention Epicenter Program has made possible two separate randomized controlled trials to further examine this promising approach to preventing HAIs. We look forward to the results of those studies.

Is your facility involved in prevention research?

Posted on by CDC's Safe Healthcare Blog

5 comments on “Where Innovation Meets Prevention: HAI Prevention Research”

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    Great comments. There is a recent Australian study that eliminated MRSA with proper surface sanitizing plus every one wearing a clean plastic apron every visit.
    What is the retrofit expense of microbe killing surfaces?
    Please do not stop sanitizing your hands thoroughly. Patients should still sanitize their hands before they EAT also. They do not get the opportunity in most hospitals.
    They do not even wash their hands thoroughly after a BM.
    American alcohol foams are much weaker that the European standard. 70% w/w is what is needed not 62%.
    Most people do not follow all 7 WHO steps in their hand hygiene routine. If you do not do all these EASY steps you are leaving big swatches of killer germs on your hands. If you do it (Hand cleansing) right at the right times you will be decreasing your patient’s risk of HAI.

    “There could be new and effective strategies out there remaining to be discovered. ”

    There already are strategies out there that have been discoverd that CDC continues to ignore.
    ADI is proven successful in numerous settings and different countries. You co_wrote the 2002 SHEA MRSA recommendation. Now you oppose the use of ADI with decolonization as indicated for MRSA prevention.
    Until we all recognized MRSA colonization as a threat to hospital inpatients, and screen vulnerable high risk patients, isolate those who are positive and use contact precautions including gloves, gowns and masks as indicated, MRSA endemics all over the country and world will continue.
    The successful study using MRSA ADI at all of the VA hospitals in the US is being ignored and snubbed by CDC. I don’t pretend to understand that. We should be implementing MRSA ADI in all US hospitals. It is a proven method of prevention and will drastically reduce HA MRSA.
    Handwashing is an important componant of any IC program, but it is not the silver bullet. It’s time to expand the program.

    This report is great news about reducing HAI contmination and how simple it is to do with a daily bath using antimicrobial soap. This should also be easy for hospitals to implement. I can give you my experience I had with a large hospital in Southern California when I got my HAI from a catheter line. I had a seazure and broke my back when I hit something on the way to the floor. I was in the hospital for two weeks but I had one patient bath in that time on the day I was transferred from the hospital to the nursing home. I was at the nursing home 3 weeks before I went home and had 3 baths in that time because it was the nursing home’s policy that each patient get one bath each week. My HAI stayed with me the whole time I was in the nursing home and when I got home I still had it. I had to go back to the hospital a month or so later for another seazure and they started antibiotic treatments then and eliminated the HAI. But the resident that started treating me on the second hospital visit at first thought I had an STD and was checking for that before he realized I had an HAI. The daily bath would be a good thing to control HAIs especially if combined with proper care and sanitizing of things like IV lines and catheter lines. Best wishes, Michael E. Bailey.

    I just read your blog on the CDC website and I’m encouraged by your views and the CDC’s proactive approach to funding studies that may result in evidence-based procedures to reduce the HAI rates. I am interested in how the broad application of antimicrobial coatings to surfaces in the healthcare setting can help in reducing cross-contaminations and possibly infections. The products available have been studied in the laboratory and anecdotally in clinical and real world settings. I believe the reward of a multi-site study of these types of treatments would have great benefit to the industry.

    I would be very interested in your opinions on the role that antimicrobial surfaces could play in the war against HAI rates.

    I’m curious about the statement in the article:

    “This is where prevention research comes in. We need to increase our arsenal of weapons if we hope to get close to the goal of eliminating HAIs”

    1. If MRSA can exist on common surfaces for up to six weeks, and can mutate and multiply many times in that period, why is healthcare (and the CDC) almost solely focused on hand hygiene?

    2. Additionally, in light of other HAIs such as C. Diff. or even the flu, which are clearly airborne, and finally recently documented as such, why is Healthcare solely focused on hand hygiene?

    3. I might point out several infectious disease experts who have attested publicly that evidence demonstrates that hand hygiene does very little to combat the flu, C. Diff. and some other HAI occurences.

    Last, if healthcare needs to embrace additional technologies- why hasn’t it? There have been available technologies for 10-30 years which could reduce HAI incidents by up to 90%. The government, the military and others are using them- why isn’t healthcare.

    Here are some of the technologies available, at least to New England healthcare:

    – Chemical free, VOC free coatings which mechanically and continually destroy any microbe, including NDM1 effected bacteria, on almost any healthcare surface, CONTINUALLY, between cleanings for months at a time, have demonstrated continual 90% surface microbe reduction and matching incident reductions.

    – UV Light and Ozone-Free Bipolar ionization air sterilization for HVAC Systems, or for portable use in single rooms, which destroy and remove 90%+ of all airborne particulate contagions, including spores, flu, etc.

    I applaud the encouragement of embracing new tools for the arsenal of HAI prevention. I would humbly submit, that in light of the billions lost on this annually, and the immense suffering and loss of life, that talk is great, but the time for action is overdue.

    S. Blevins

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