National, state data show ongoing efforts needed help fight healthcare-associated infections

Progress has been made in the effort to eliminate infections that commonly threaten hospital patients, but more work is needed to improve patient safety, according to 2 reports released by the Centers for Disease Control and Prevention (CDC).

The first one is the CDC Multistate Point-Prevalence Survey of Health Care-Associated Infections published in the New England Journal of Medicine detailing 2011 national healthcare-associated infection (HAI) estimates from a survey of hospitals in 10 states, and the other is a 2012 annual report on national and state-specific progress toward US Health and Human Services HAI prevention goals.

“Recent data from the State HAI Progress Report, published at the same time as the prevalence survey results, suggest that progress has been made in certain areas,” said Shelley S. Magill, MD, PhD, a medical officer in CDC’s Division of Healthcare Quality Promotion. “However, from the survey data we’ve estimated that almost three-quarters of a million healthcare-associated infections occurred in acute care hospital patients in 2011, so more action is needed to prevent these infections."

Out of the 11,282 patients included in the survey, about 4%, or 1 in 25 patients, had at least 1 HAI infection at the time of the survey.

The researchers used data from the survey to estimate the total burden of HAIs in US acute care hospitals in 2011. They estimated that there were 721,800 such infections in approximately 648,000 patients.

The most common types of infections were surgical-site infections (22% of all HAIs), pneumonia (22%), gastrointestinal tract infections (17%-many of these infections were due to Clostridium difficile), urinary tract infections (13%), and bloodstream infections unrelated to infections at other sites (10%).

C difficile was the most common pathogen reported, causing 12% of all HAIs, followed by Staphylococcus aureus, including MRSA (11%), Klebsiella (10%), E. coli (9%), Enterococcus (9%), and Pseudomonas (7%). Klebsiella and E. coli are members of the Enterobacteriaceae bacteria family, which has become increasingly resistant to last-resort antibiotics known as carbapenems.

“The survey results help to clarify the relative burden of different types of HAIs and pathogens hospital-wide,” Dr Magill said. “They also suggest areas to target for prevention and infection types about which we need to know more.”

For example, C difficile infections were very common in this survey; this finding supports ongoing, intensive C difficile infections prevention efforts, including efforts to improve antimicrobial use in hospitals, according to Dr Magill.

“In addition, we saw in the survey that pneumonia in patients not on mechanical ventilators was quite common-these are infections that we need to understand better, so that we can better prevent them in the future,” she said. “Another finding was that most HAIs detected in the survey began outside of critical care units, so expanding surveillance and prevention to these non-critical care unit locations in hospitals is also very important.”