Hospital Medicine

Hospital-Acquired Infection Rates Have Decreased Since 2011

The prevalence of health-care–associated infections (HAIs), including surgical site infections (SSIs) and urinary tract infections (UTIs), was lower in 2015 vs 2011, according to a recent study. However, the proportions of patients with pneumonia and Clostridium difficile infection (CDI) were similar during both periods.

Findings from the study were presented at ID Week, which took place from October 4 to 8, 2017, in San Diego, California.
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According to a prevalence survey conducted by CDC and the Emerging Infections Program (EIP), approximately 1 in 25 hospital patients had 1 or more HAIs in 2011.

For the study, several EIP sites and hospitals across the United States that had participated in the 2011 survey were recruited for the 2015 survey. Each site selected 1 day between May 2015 and September 2015, during which a random sample of patients was identified via the morning census. Patient characteristics including median age, days from admission to survey, and critical care location were similar.

Patient medical records were reviewed by trained EIP staff, using comparable methods and the same National Healthcare Safety Network definitions of HAI that had been used in 2011.

The researchers assessed data from 143 hospitals that had participated in both surveys, and patient data from the 2011 survey (n = 8954) and the 2015 survey (n = 8833) were compared. Ultimately, the proportion of patients with HAIs had been lower in 2015 (3.2%) than in 2011 (4.0%). Pneumonia and CDI were the most common infections in 2015, and the proportions of patients with pneumonia or CDI were similar in both 2011 (1.5%) and 2015 (1.5%). However, the proportion of patients with SSIs or UTIs had decreased between 2011 (0.9%) and 2015 (1.5%)

The researchers noted that the prevalence of urinary catheters was lower in 2015 (18%) vs 2011 (22.9%), as was the prevalence of central lines (17.4% in 2011 vs 3.2% in 2015).

“HAI prevalence was significantly lower in 2015 compared to 2011,” the researchers concluded. “This is partially explained by fewer SSI and UTI, suggesting national efforts to prevent SSI, reduce catheter use and improve UTI diagnosis are succeeding. By contrast, there was no change in the prevalence of the most common HAIs in 2015, [pneumonia] and CDI, indicating a need for increased prevention efforts in hospitals.”

—Christina Vogt

Reference:

Magill SS, Wilson LE, Thompson DL, et al. Reduction in the prevalence of healthcare-associated infections in U.S. acute care hospitals, 2015 versus 2011. Paper presented at: ID Week 2017; October 4-8, 2017; San Diego, California. https://idsa.confex.com/idsa/2017/webprogram/Paper63280.html.