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Hospitalwide surveillance reduces HAI incidence
The implementation of extensive, hospitalwide surveillance and control measures for preventing health care-associated infections reduced infection rates, mortality and costs, according to recent data.
In the retrospective, observational study, researchers evaluated health care-associated infection (HAI) data from the University of North Carolina Hospitals, a 806-bed, tertiary care academic facility. Data were collected between 2001 and 2012.
HAIs were identified through laboratory reports, blood and molecular-based diagnostic testing, morbidity and mortality conferences, autopsies and infection reports. Classifications included: bloodstream infections (BSIs); urinary tract infections (UTIs); respiratory tract infections (RTIs), including pneumonia and lower RTIs (LRTIs); surgical site infections; soft-tissue infections; and cardiovascular system infections.
The annual number of HAIs averted by infection control strategies was determined by calculating the risk reduction from the difference in infection incidence between years. This allowed the researchers to determine the total number of HAIs prevented over the past decade and to evaluate the incidence rate difference by infection type over time.
There were 16,579 HAIs observed during the study period; 6,397 cases occurred in ICUs, the remainder occurred outside ICU settings. The hospitalwide incidence of overall HAIs was reduced by 3.4 infections per 1,000 patient-days, and ICU HAIs decreased by 8.4 infections per 1,000 patient-days. In non-ICU hospital sites, HAI incidence declined by 1.9 infections per 1,000 patient-days. The incidence of overall HAIs decreased hospitalwide (3.39 infections per 1,000 patient-days; P < .001), in ICUs (8.39 infections per 1,000 patient-days; P < .001), and in non-ICU settings (1.92 infections per 1,000 patient-days; P < .001). While BSI, UTI and pneumonia occurrences decreased hospitalwide, the incidence of SSI and LRTIs remained stable and Clostridium difficile infection incidence increased. Estimated outcomes included 714 overall HAIs averted, 41 lives saved and savings of more than $10 million during the study period.
These findings add to the existing evidence derived from point-prevalence surveys and other methods, according to the investigators.
“Point-prevalence surveys of HAIs at multiple centers have several limitations regarding representativeness and validation for data collection and the use of formula of prevalence to incidence conversions,” the researchers wrote. “Thus, this study, even at a single tertiary care facility, has the strength of longitudinal data regarding all HAIs through comprehensive hospitalwide surveillance, including HAIs that could not be detected by targeted surveillance.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.