Major Finding: Central line–associated bloodstream infections were reduced by 18% nationwide in 2009.
Data Source: CDC health care–associated infection summary data report of national and state specific infections.
Disclosures: None was reported.
The overall number of central line–associated bloodstream infections during the first half of 2009 in states with legislative mandates to report such infections was 18% lower than predicted based on national estimates from the previous 3 years.
That finding emerged from a health care–associated infections (HAIs) summary report issued by the Centers for Disease Control and Prevention that includes overall national data on central line–associated bloodstream infections (CLABSIs) and, for the first time, state-specific data from health care facilities in states that mandate CLABSI reporting to the CDC's National Healthcare Safety Network, according to Dr. Don Wright, deputy assistant secretary for healthcare quality in the Department of Health and Human Services' Office of Public Health and Science.
The report also compares national and state data from January to June 2009 with national data from 2006 to 2008 using standardized infection ratio (SIR) calculations.
The report is a “benchmark for progress” on the national goals of the HHS Action Plan to Prevent Healthcare-Associated Infections (www.hhs.gov/ophs/initiatives/hai
According to the report, in the 17 states that, as of June 30, 2009, had mandated the reporting of CLABSIs to their state health departments, 1,538 health care facilities reported 4,615 CLABSIs from January to June 2009—nearly 1,000 fewer than the 5,619 that were predicted.
Eleven of the 17 states had an SIR significantly less than the nominal value 1.0 (representing the number of expected infections), while only 2 had SIRs that were significantly higher than 1.0, said Dr. Arjun Srinivasan, associate director for the CDC's Healthcare-Associated Infection Prevention Program. In nearly all of the states with mandated reporting, at least 25% of health care facilities reported no CLABSIs, the report noted.
Although the initial results are encouraging and represent early progress in the comprehensive strategy to reduce, prevent, and ultimately eliminate HAIs outlined in the HHS Action Plan, the current report “is only the first step,” Dr. Srinivasan said, noting that the “real tests” will be every 6 months, with the release of updated reports that allow comparisons of state-specific progress over time.
Although the summary report uses an SIR of 1.0 to indicate the predicted number of CLABSIs, “1.0 is not our ultimate goal. The ratio can be reduced much further,” Dr. Srinivasan said, noting that most CLABSIs are preventable. The 18% national reduction observed thus far reflects a broader implementation of infection control guidelines, enhanced tracking and measurement, and the combined efforts of clinicians, state health departments, federal agencies, professional organizations, and consumer advocates to enhance prevention efforts, “but more still has to be done” to meet the goal of a 50% reduction by 2013 outlined in the action plan, he said.
The Association for Professionals in Infection Control and Epidemiology (APIC) said in a statement that it was encouraged by the report's findings. “Many of our member facilities have seen that central line–associated bloodstream infections can be reduced to zero, and that in many instances 'zero' can be maintained,” the APIC said.
The CDC report is found at www.cdc.gov/hai/statesummary.html