US Health Care-Associated Infection Progress Report Shows Some Improvement

Last week was International Infection Prevention Week, which means it was a perfect time to discuss the importance of infection prevention and all the ways we prevent the spread of disease in health care. The results of a new report from the US Centers for Disease Control and Prevention (CDC) indicate that we’ve made great strides in preventing health care-associated infections over the past several years; however, we still have a way to go.

Health care-associated infections represent a serious threat to patient safety and health. The CDC reports that on any given day, 1 out of 25 hospitalized patients will have at least 1 health care-associated infection. The risk for health care-associated infections is even higher in developing countries, where 10 of every 100 patients who are hospitalized will acquire at least 1 health care-associated infection.

In response to the growing threat of health care-associated infections, the CDC has been working with hospitals to strengthen their infection prevention efforts for the past several decades. Recent efforts have been streamlined and refined to address certain infections, such as central line-associated bloodstream infections (CLABSI), that carry considerable morbidity and mortality, but are also preventable with evidence-based practices.

In 2009, the US Department of Health and Human Services published a national action plan to combat health care-associated infections, which included a roadmap to elimination. Within the roadmap, there were 5-year goals, and the second phase five-year goals began in 2015 and will run to 2020.

Recently, the CDC released the latest 2016 progress report, which detailed health care-associated infection prevention progress state-by-state and on a national level. The published data is from 2016 and reveals progress made from 2015. Between legislation tying Medicare reimbursement to health care-associated infection reporting and rates, as well as state-mandated public reporting, there have been significant efforts to make a dent in the epidemic of health care-associated infections in the United States.

The good news is that we’ve made some good progress. At a national level, CLABSI rates have dropped by 11%, while catheter-associated urinary tract infections (CAUTIs) have dropped 7%. Ventilator-associated events (VAE) have decreased by 2%, and surgical site infections (SSI) related to the 10 selected procedures that are tracked have dropped by 6%. Of these SSIs, there has been a 13% decrease in abdominal hysterectomy infections and a 7% decrease in colon surgery infections. Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia has decreased by 7% and there has been an 8% drop in Clostridium difficile infections.

When looking at state-specific progress, the CDC found that 38 states performed better on at least 2 types of infections. A total of 27 states had acute care hospitals that performed better than the 2015 national baseline in CLABSI reduction, while 22 states did so with CAUTI performance when compared to the national baseline. Clostridium difficile infection prevention was successful across 26 states, as they also performed better in 2015 than the national baseline.

Unfortunately, there is still much work to be done. Several states showed performances worse than the national baseline: 5 states performed worse in CAUTI prevention, 4 states in CLABSI prevention, and 6 states performed worse in MRSA bacteremia and Clostridium difficile infection prevention.

Continued publication of the national and state-by-state data is critical to understand the prevalence of health care-associated infections, and to support infection prevention efforts. Infection prevention, like public health programs, is often seen as a cost center and not a revenue generator, which can translate to limited resources and support. Although it is important to recognize the progress we have made in reducing health care-associated infections, it is critical to understand the efforts that go into reduction. Hospitals must continue to invest in and support infection prevention programs and processes to help reduce the burden of health care-associated infections on the American health care system and the public if we are ever going get close to eliminating health care-associated infections.