Health care–associated infection rates going down

Background: HAIs are key drivers of morbidity and mortality for hospitalized patients. In 2011, the Centers for Disease Control and Prevention (CDC) conducted a point-prevalence survey that revealed an HAI in 4% of hospitalized patients. The most common infections included pneumonia, gastrointestinal infections, and surgical-site infections. Over time, efforts in patient safety and quality have expanded to reduce the rate of HAIs. This same survey was repeated in 2015 to assess for improvements.

Study design: Point-prevalence survey.

Setting: A collection of 199 Emerging Infection Program hospitals in 10 states.

Synopsis: Of 12,299 patients surveyed, 3.2% (95% confidence interval, 2.9%-3.5%) were found to have at least one HAI. This was a statistically significant reduction compared to the prevalence of 4% (95% CI, 3.7%-4.4%) found in the 2011 study. Approximately 75% of patients were on a medical ward, and 15% of patients were in the ICU. The age and sex of patients were similar to those of patients in the 2011 study.

The reduction in HAIs was primarily driven by a reduction in surgical-site infections and urinary tract infections. There was no reduction in the prevalence of health care–associated pneumonia, Clostridium difficile infection, or mortality. Consequently, this emphasizes the necessity of further work in these domains.

Bottom line: The overall prevalence of HAIs has decreased, but further quality improvement work is needed in order to expand this reduction to health care–associated pneumonia, C. difficile infection, and mortality from HAIs.

Citation: Magill SS et al. Changes in prevalence of heath care–associated infections in U.S. hospitals. N Engl J Med. 2018;379(18):1732-44.

Dr. McIntyre is an associate physician in the division of hospital medicine at the University of California, San Diego.

Background: HAIs are key drivers of morbidity and mortality for hospitalized patients. In 2011, the Centers for Disease Control and Prevention (CDC) conducted a point-prevalence survey that revealed an HAI in 4% of hospitalized patients. The most common infections included pneumonia, gastrointestinal infections, and surgical-site infections. Over time, efforts in patient safety and quality have expanded to reduce the rate of HAIs. This same survey was repeated in 2015 to assess for improvements.

Study design: Point-prevalence survey.

Setting: A collection of 199 Emerging Infection Program hospitals in 10 states.

Synopsis: Of 12,299 patients surveyed, 3.2% (95% confidence interval, 2.9%-3.5%) were found to have at least one HAI. This was a statistically significant reduction compared to the prevalence of 4% (95% CI, 3.7%-4.4%) found in the 2011 study. Approximately 75% of patients were on a medical ward, and 15% of patients were in the ICU. The age and sex of patients were similar to those of patients in the 2011 study.

The reduction in HAIs was primarily driven by a reduction in surgical-site infections and urinary tract infections. There was no reduction in the prevalence of health care–associated pneumonia, Clostridium difficile infection, or mortality. Consequently, this emphasizes the necessity of further work in these domains.

Bottom line: The overall prevalence of HAIs has decreased, but further quality improvement work is needed in order to expand this reduction to health care–associated pneumonia, C. difficile infection, and mortality from HAIs.

Citation: Magill SS et al. Changes in prevalence of heath care–associated infections in U.S. hospitals. N Engl J Med. 2018;379(18):1732-44.

Dr. McIntyre is an associate physician in the division of hospital medicine at the University of California, San Diego.

Background: HAIs are key drivers of morbidity and mortality for hospitalized patients. In 2011, the Centers for Disease Control and Prevention (CDC) conducted a point-prevalence survey that revealed an HAI in 4% of hospitalized patients. The most common infections included pneumonia, gastrointestinal infections, and surgical-site infections. Over time, efforts in patient safety and quality have expanded to reduce the rate of HAIs. This same survey was repeated in 2015 to assess for improvements.

Study design: Point-prevalence survey.

Setting: A collection of 199 Emerging Infection Program hospitals in 10 states.

Synopsis: Of 12,299 patients surveyed, 3.2% (95% confidence interval, 2.9%-3.5%) were found to have at least one HAI. This was a statistically significant reduction compared to the prevalence of 4% (95% CI, 3.7%-4.4%) found in the 2011 study. Approximately 75% of patients were on a medical ward, and 15% of patients were in the ICU. The age and sex of patients were similar to those of patients in the 2011 study.

The reduction in HAIs was primarily driven by a reduction in surgical-site infections and urinary tract infections. There was no reduction in the prevalence of health care–associated pneumonia, Clostridium difficile infection, or mortality. Consequently, this emphasizes the necessity of further work in these domains.

Bottom line: The overall prevalence of HAIs has decreased, but further quality improvement work is needed in order to expand this reduction to health care–associated pneumonia, C. difficile infection, and mortality from HAIs.

Citation: Magill SS et al. Changes in prevalence of heath care–associated infections in U.S. hospitals. N Engl J Med. 2018;379(18):1732-44.

Dr. McIntyre is an associate physician in the division of hospital medicine at the University of California, San Diego.