CDC Report Finds Declines in Key HAIs, but No Significant Change in Others: Public Health Watch

American hospitals are becoming, for lack of a better phrase, less sick.

That’s essentially the conclusion of the US Centers for Disease Control and Prevention’s (CDC) 2018 National and State Healthcare-Associated Infections (HAI) Progress Report, released on November 1^st. Among other findings, the annual assessment revealed that, in US hospitals, there was:

• A 9% reduction in central line-associated bloodstream infections (CLABSIs) between 2017 and 2018, with the most significant declines (11%) found in ICUs;
• An 8% reduction in catheter-associated urinary tract infections (CAUTIs) between 2017 and 2018, with again the largest decrease (10%) found in ICUs; and,
• A 12% reduction in hospital-onset Clostridioides difficile infections between 2017 and 2018.

“We know that many of these infections are preventable,” Arjun Srinivasan, MD, associate director, HAI Prevention Programs, CDC, told Contagion®. “Tracking HAIs helps hospitals and patients monitor how well we’re doing at preventing infections and helps direct us to places where more work is needed. Hospitals have done a fantastic job at implementing proven prevention strategies and empowering healthcare personnel to deliver safer care. That said, we know there is always more we can do and CDC continues to explore ways to partner with health care providers and others to find more and better ways to prevent infections.”

The report summarizes current trends for select HAIs across 4 health care settings: acute care hospitals (ACHs), critical access hospitals (CAHs), inpatient rehabilitation facilities (IRFs), and long-term acute care hospitals (LTACHs). The designation of CAH is assigned by the Centers for Medicare and Medicaid Services (CMS) to hospitals with 25 or fewer acute-care inpatient beds that maintain an annual average length of stay of 96 hours or less. In addition, IRFs include hospitals that provide intensive rehabilitation services using an interdisciplinary team approach, while LTACHs provide treatment for patients who are generally very sick and stay, on average, more than 25 days.

In all, the document includes data from more than 22,000 active hospitals and health care facilities that report to the CDC’s National Healthcare Safety Network (NHSN), the nation’s most widely used HAI surveillance system, which is used to develop targeted prevention initiatives by health care facilities, states, regions, quality groups, and national public health agencies.

Although most of the key indicators for HAIs noted above are positive, not all of the news for 2018 was good. The report also documented “no significant change” in ventilator-associated events (VAEs) and surgical site infections (SSIs; related 10 select procedures tracked) between 2017 and 2018, including in the latter group SSIs following abdominal hysterectomy and colon surgery. In addition, the report indicates there were no significant changes in hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bloodstream events between 2017 and 2018.

Noted Srinivasan: “Hospitals can review current recommendations for best practices to prevent infections from groups like CDC and then use that information to assess their practices to see where there might be opportunities for improvement.”