CDC reports new data on hospital-acquired infections

The CDC released 2 different reports on hospital-acquired infection (HAI) rates in the U.S. last week.

First, data from the National Healthcare Safety Network (which includes more than 12,500 hospitals and health care facilities) was used to compare hospital infection rates from 2008 to 2012. The resulting HAI Progress Report showed significant reductions in several kinds of infections nationally in that time period, including a 44% decrease in central line-associated bloodstream infections (CLABSIs) and a 20% decrease in the measured surgical-site infections. These improvements approach 5-year goals set by the agency in 2009, the report noted.

However, decreases in methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile were minimal between 2011 and 2012 (4% and 2%, respectively). Catheter-associated urinary tract infections actually increased 3% between 2009 and 2012. Additional preventive efforts are needed for these types of infections, the report concluded. State-specific rates of HAIs were also measured and, although there were significant variations, no states performed above the national average on all 4 measured infection types. The full report, including individual state statistics, was published online by the CDC.

To determine the prevalence of hospital-acquired infections other than those 4 types reported to the Safety Network, CDC researchers also conducted a 1-day survey in 2011 of the medical records of more than 11,000 patients from 183 hospitals across the country. Results from this survey were reported in the March 27 New England Journal of Medicine.

Four percent of the surveyed patients had at least 1 hospital-acquired infection (95% CI, 3.7 to 4.4). The most common types were pneumonia (21.8%), surgical-site infections (21.8%), and gastrointestinal infections (17.1%). Clostridium difficile caused more than two-thirds of the gastrointestinal infections and was the most commonly reported pathogen overall (responsible for 12.1% of the infections), although researchers noted that their definition of C. difficile infection was very sensitive.

Although device-associated infections (such as CLABSI) have gained much attention in recent years, they accounted for only 25.6% of the studied infections, the researchers noted. The focus of prevention efforts should be expanded to include HAIs that are not associated with devices or procedures, they recommended. Overall, the survey found lower rates of HAIs than older estimates, but these measurements are difficult to compare, the authors said. They concluded that about 1 in 25 U.S. hospital patients develops an HAI and that there were 648,000 patients with 721,800 HAIs in U.S. hospitals in 2011.