Release f CDC s Healthcare-Assciated Infectins (HAI) Pint Prevalence Survey and Annual Natinal and State HAI Prgress Reprt Embarged until: Wednesday, March 26 th at 12 nn ET Key Messages Overall These reprts shw that significant prgress is being made, but three-quarters f a millin infectins still threaten hspital patients. Mre actin is needed at every level f public health and health care. Althugh these reprts fcus n hspitals, we knw there are many infectins ccurring in ther healthcare settings such as nursing hmes, dialysis facilities, and utpatient surgery centers. CDC HAI Prevalence Survey This survey helps us better understand the full spectrum f healthcare-assciated infectins in hspitals beynd thse traditinally tracked by the Natinal Healthcare Safety Netwrk (NHSN), e.g., thse ccurring utside f intensive care units (ICU). This infrmatin shws what new challenges are likely t require preventin effrts mving frward. Bttm line: Prgress is being made, but there is much mre wrk t be dne t prevent the wide spectrum f infectins still cmmn in hspitals. Key Data Pints: On any given day, abut 1 in 25 hspital patients has at least ne healthcare-assciated infectin. 4% f hspitalized patients had ne r mre HAI. There were an estimated 722,000 HAIs in U.S acute care hspitals in 2011. Abut 75,000 hspital patients with HAIs died during their hspitalizatins. The CDC HAI prevalence survey prvides an updated natinal estimate f the verall prblem f healthcareassciated infectins in U.S. hspitals Based n a large sample f U.S. acute care hspitals The mst cmmn infectin types were: pneumnia (22 percent) surgical site infectins (22 percent) gastrintestinal infectins (17 percent) urinary tract infectins (13 percent), and bldstream infectins unrelated t an infectin at anther site (10 percent) The mst cmmn germs causing healthcare-assciated infectins were: C. difficile (12 percent) Staphylcccus aureus (11 percent including MRSA)
Klebsiella (10 percent)* E. cli (9 percent)* Entercccus (9 percent) Pseudmnas (7 percent) *Klebsiella and E. cli are members f the Enterbacteriaceae family; several germs in this family are shwing strng antibitic resistance and are knwn as carbapenem-resistant Enterbacteriaceae (CRE), r nightmare bacteria. Mre than half f all nn-prcedure-related HAIs ccurred utside f the intensive care unit (ICU). CDC cntinues t wrk with hspitals and ther partners t ensure HAI surveillance and preventin effrts are used utside f ICU settings as well. Device-assciated infectins, such as central-line assciated bldstream infectins (CLABSI), which have been a successful fcus f HAI preventin, nw accunt fr nly 26% f all HAIs detected. These data indicate that effrts are needed t better understand risk factrs and preventin strategies fr ventilatr-assciated pneumnia and pneumnia nt related t ventilatr use. The high prevalence f C. difficile underscres the need t imprve antibitic prescribing in inpatient and utpatient envirnments. In additin t the nging tracking f C. difficile by NHSN, the CDC survey prvides mre detailed infrmatin, including cmmunity-nset infectins fr C. difficile infectins thrugh the Emerging Infectins Prgrams, t further assess the causes and preventin pprtunities fr these infectins (http://www.cdc.gv/hai/eip/clstridium-difficile.html). In additin, CDC recently called n all hspitals t implement prgrams t imprve antibitic prescribing as a measure t reduce C. difficle infectins and t reduce antibitic resistance (http://www.cdc.gv/vitalsigns/antibitic-prescribing-practices/). CDC Natinal and State HAI Prgress Reprt This is an annual reprt that gives a clser lk at the healthcare-assciated infectins mst cmmnly reprted t CDC. Mst preventin fcus t date has been related t these infectins. This annual reprt describes state prgress in CLABSI, CAUTI, SSIs after cln surgery and SSI after abdminal hysterectmy. The reprt is based n 2012 data. Bttm line: many states are making prgress, but mre wrk is needed acrss the cuntry.
Key Data Pints: Natinally, prgress is being made in sme categries. CLABSI 44% decrease since 2008 Amng cmbined rates fr 10 surgical prcedures 20% decrease between 2008 and 2012 SSIs after cln surgery 20% decrease since 2008 SSIs after abdminal hysterectmy 11% decrease since 2008 Hspital-nset C. difficile Infectin (deadly diarrhea) 2 percent decrease since 2011 Hspital-nset MRSA 4 percent decrease since 2011 Overall, healthcare-assciated invasive MRSA has decreased 31% since 2008 And a slight increase was seen fr: CAUTI 3% increase since 2009 State-by-state metrics were presented n fur infectin types: CLABSI, CAUTI, and surgical site infectins due t cln surgery and t abdminal hysterectmy surgery. State prgress varies verall and per each infectin type. Nne f the 50 states, Washingtn, D.C., r Puert Ric perfrmed better than the natinal SIR n all fur infectin types 16 states perfrmed better than the natinal SIR n at least tw infectins, including 2 states perfrming better n three infectins. 16 states perfrmed wrse than the natinal SIR n at least tw infectins, including 7 states perfrming wrse n at least three infectins. Backgrund n the CDC HAI Prevalence Survey This is the largest CDC-led prevalence survey f healthcare-assciated infectins in mre than 30 years. This survey was cmpleted thrugh the Emerging Infectins Prgram (EIP), a netwrk f state health departments, academic medical centers and ther partners dedicated t imprving surveillance, preventin, and cntrl f emerging infectius diseases. Acute care hspitals in each f the fllwing EIP site states participated in the survey: Califrnia, Clrad, Cnnecticut, Gergia, Maryland, Minnesta, New Mexic, New Yrk, Oregn, and Tennessee. There were three phases f survey develpment Over a 3-year perid, CDC wrked t refine its HAI pint prevalence survey methdlgy in cllabratin with persnnel in participating hspitals, Emerging Infectins Prgram staff, and external experts; this has included effrts t minimize burden n staff f participating hspitals while maintaining data quality. 2009 Phase 1 single-city pilt: 9 hspitals in Jacksnville, Flrida Each hspital cnducted the survey n a single day
Randm sample f acute care inpatients frm mrning census in each hspital Trained hspital staff perfrmed primary data cllectin in their wn hspitals n the survey date Expert, external infectin preventinists perfrmed separate data validatin n survey date Lessns learned fr Phases 2 and 3: Minimize data cllectin burden n hspital persnnel Ensure that all data cllectrs have the time and the medical recrds access they need t make HAI determinatins Evaluated perfrmance f prxy HAI indicatrs (abnrmal temperature r white bld cell cunt, antimicrbial therapy) T find mre efficient apprach fr identifying patients with HAIs Lessns learned fr Phases 2 and 3: Antimicrbial therapy was sensitive prxy indicatr identified 96% f patients determined t have HAIs Can be used t screen patients fr cmprehensive medical recrd review 2010 Phase 2 limited rll-ut: 22 hspitals in 10 Emerging Infectins Prgram (EIP) sites 1-3 hspitals in each site 2011 Phase 3 full-scale survey: 11,282 patients in 183 hspitals in 10 Emerging Infectins Prgram (EIP) sites Up t 25 hspitals in each site Additinal Infrmatin abut Pneumnia as an HAI Pneumnia is an infectin f the lungs that can cause mild t severe illness in peple f all ages. Peple catch pneumnia when bacteria, certain fungi, r viruses get in their lungs. Healthy peple have immune systems t fight ff these germs and the ability t cugh s they d nt breathe in pathgens r fd. Hspitalized patients are at risk fr aspiratin pneumnia, which can ccur when patients accidentally inhale fd, liquids, muth r thrat secretins, r regurgitated stmach cntents (vmit) int their lungs. Pneumnia that develps during r fllwing a stay in a healthcare facility (such as hspitals, lng-term care facilities, and dialysis centers) is called hspital-acquired pneumnia (HAP) r healthcare-assciated pneumnia (HCAP). Pneumnia that develps in a patient n a mechanical ventilatr is called ventilatrassciated pneumnia. CDC is assessing the varius types f pneumnias that ccur in healthcare settings t determine hw best t track and prevent these infectins. With ventilatr-assciated pneumnia, implementatin f infectin preventin bundles in intensive care units can reduce this patient safety threat. CDC s next challenge will be t identify preventin practices that prtect patients frm ther pneumnias.
The findings f this prevalence survey identify new areas that need attentin and guide public health planning and actin t address the next set f challenges. Many pneumnias can be prevented with available vaccines, including: pneumcccal, Haemphilus influenzae type b (Hib), pertussis (whping cugh), varicella (chickenpx), measles, and influenza (flu). Fllwing gd hygiene practices can als help prevent respiratry infectins. This includes washing yur hands regularly, cleaning hard surfaces that are tuched ften (like bedrails and cuntertps), and cughing r sneezing int a tissue r int yur elbw r sleeve. In additin the risk f getting pneumnia can be reduced by limiting expsure t cigarette smke and treating and preventing cnditins such as diabetes.