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CDC: HAI declined in US hospitals
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Fewer health care-associated infections were reported in the United States from 2008 to 2013, according to a CDC report.
Data submitted to the agency’s National Healthcare Safety Network, which receives information from more than 14,500 facilities, was published in the annual National and State Healthcare-associated Infection Progress Report. Health care-associated infection (HAI) data from eligible acute care hospitals were analyzed on a national and state level and compared with those of previous years.
It is the first report that includes state-specific information about MRSA bacteremia and Clostridium difficile infections, although a shortage of data on certain infections in some states required comparison to the national baseline, as opposed to previous results.
Changes in reported national HAI rates include:
- a 46% decrease in central line-associated bloodstream infections since 2008, and a 4% decrease since 2012;
- a 19% decrease in various surgical site infections since 2008, but no change since 2012;
- a 6% increase in catheter-associated urinary tract infections since 2009, and a 3% increase compared with 2012;
- an 8% decrease in MRSA bacteremia since 2011, and a 5% decrease since 2012;
- a 10% decrease in C. difficile infections since 2011, and a 6% decrease since 2012.
According to the press release, the CDC is working to use these findings to identify specific hospitals and wards that may benefit from additional infection control expertise. This includes collaboration with CMS and the Agency for Healthcare Research and Quality.
Thomas R. Frieden
“Hospitals have made real progress to reduce some types of health care-associated infections — it can be done,” CDC Director Thomas R. Frieden, MD, MPH, said in the release. “The key is for every hospital to have rigorous infection control programs to protect patients and health care workers, and for health care facilities and others to work together to reduce the many types of infections that haven’t decreased enough.”
Perspective
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Keith S. Kaye, MD, MPH
This report highlights notable decreases in a variety of health care-associated infections at a national level. Of note, CLABSI decreased by 46% from 2008-2013, and SSI decreased 19% during this same time period. Decreases were more modest for CAUTI, MRSA and CDI. Reductions likely reflect in part, improved adherence and implementation of infection prevention processes and bundles. The data are limited by changes in surveillance definitions (particularly notable for CAUTI) and diagnostics (particularly for CDI). Also, there is not a robust method for validating infection diagnoses in this data set, and to some degree, changes in public reporting, value-based purchasing and HAC-related penalties that occurred during the reporting period might have influenced surveillance methods, processes and reporting (particularly for CLABSI and CAUTI).
CDC notes that although much progress has been made, there is still much room for improvement — approximately one in 25 US patients has at least one infection contracted during the course of their hospital care. We have come a long way, but still have a long way to go.
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