Health care-associated infection risk decreases 22% in US hospitals

SAN DIEGO — Patients seen at acute-care hospitals in the United States were 22% less likely to acquire a health care-associated infection in 2015 than in 2011, according to recent survey data.

“The results suggest that national efforts to prevent health care-associated infections (HAIs) are succeeding,” Shelley S. Magill, MD, PhD, of the CDC’s Division of Healthcare Quality Promotion, said during a presentation at IDWeek.

Magill and colleagues conducted surveys in 148 acute-care hospitals in California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to assess the prevalence of specific HAIs. All 148 hospitals that participated in both the 2011 and 2015 surveys selected one date each year between May 1 and Sept. 30 to conduct the survey on a random sample of patients. The researchers compared patients surveyed in 2011 (n = 9,283) with those surveyed in 2015 (n = 9,169).

At the time of the survey, 4.1% (95% CI, 3.7%-4.6%) of patients had an HAI in 2011 vs. 3.2% (95% CI, 2.9%-3.6%) in 2015 (P = .001). After adjusting for patient and hospital factors, the researchers estimated that the risk for developing an HAI was 22% lower in 2015.

A lower proportion of patients surveyed in 2015 had a urinary catheter (18.8% vs. 23.2%; P < .001) or central line (17.6% vs. 19%; P = .01) on the survey date. However, the proportion of patients receiving antimicrobials remained high at approximately 50%.

Magill said the overall reduction in HAIs was largely due to reductions in surgical site infections (SSIs), which decreased from 1% in 2011 to 0.59% in 2015 (P = .001), and urinary tract infections (UTIs), which decreased from 0.55% to 0.35% (P = .04).

“Our findings of decreased UTI prevalence as well as decreased urinary catheter prevalence suggest that reduced catheter use and improved UTI diagnostic practices are having an impact,” Magill said. “Explaining reductions in SSI prevalence is more complex, but it’s possible that compliance with recently updated surgical prophylaxis guidelines and uptake of SSI prevention strategies such as appropriate site preparation and preoperative infection prevention measures play a role.”

Meanwhile, the prevalence of other major HAI types such as Clostridium difficile and pneumonia remained unchanged. Pneumonia was reported in 0.99% of patients in 2011 and 0.87% in 2015. C. difficile infection (CDI) was reported in 0.56% of patients in 2011 and 0.59% in 2015.

“Given that pneumonia continues to account for a large proportion of HAIs in hospitals, more work is needed to identify risk factors, understand the extent to which infections are particularly preventable, and develop effective prevention approaches,” Magill concluded. “Finally, continued focus on improving antimicrobial use as well as isolation precautions and environmental infection control approaches are critical to achieving reductions in CDI.” – by Stephanie Viguers

Reference:

Magill SS, et al. Abstract 1768. Presented at: IDWeek; Oct. 4-8, 2017; San Diego.

Disclosures: The authors report no relevant financial disclosures.