Two new studies from the CDC offer the most comprehensive look to date at the prevalence of health care-acquired infections (HAIs) in the United States. Although the rate of HAIs has dropped in recent years, an estimated 75,000 patients died of the complications in 2011.
NEJM study: One in 25 hospital patients gets an infection
One in 25 patients treated at U.S. hospitals acquires an infection during their stay, despite notable progress in controlling the spread of lethal pathogens over the past decade, according to a study published Wednesday in NEJM.
The study represents CDC's first nationally representative count of hospital infections, which cause thousands of deaths every year. Based on a survey of 183 hospitals in 10 states in 2011, the researchers determined that there were about 721,800 HAIs health care-associate infections (HAIs) in 648,000 patients in 2011. About 75,000 of those patients died as a result.
According to the study, the most common hospital-acquired infections are:
- Pneumonia (22%);
- Surgical site infections (22%);
- Gastrointestinal infections (17%);
- Urinary tract infections (13%); and
- Bloodstream infections (10%).
The most common culprit of infection was the bacterium Clostridium difficile, which kills approximately 14,000 people in the United States each year. The pathogen was detected in 12% of patients with HAIs in 2011 and accounted for 71% of all gastrointestinal infections.
In second CDC study, researchers report progress
C. diff—along with methicillin-resistant staphylococcus aureus (MRSA), another common pathogen that has become increasingly resistant to antibiotics—comprise the majority of HAIs, says Michael Bell, deputy director of CDC's division of health care quality promotion. However, other common hospital-acquired infections seem to have become less prevalent.
In a separate CDC report also released on Wednesday, researchers found that:
- Central line-associated bloodstream infections decreased by 44% from 2008 to 2012;
- Infections from common surgical procedures declined by 20% over the same period; and
- Catheter-associated urinary tract infections rose 3% from 2009 to 2012.
"As a nation we're moving in the right direction but there's still a lot of work to be done," Bell says. For instance, he highlighted troubling gaps in performance among states. Hospital infection rates can even vary significantly among neighboring hospitals.
Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, called on patients to take a more active role in reducing infection rates by holding their providers accountable for washing their hands and researching their local hospital's infection rates on CMS's Hospital Compare website.
"Even though we've had great success nationally, there still are pockets of hospitals that have rates of infection that are several times the national average. The reality is that oftentimes there's very little that's being done about it," Pronovost says, adding, "There's no accountability for a hospital that has very high infection rates, and my sense is, there absolutely needs to be" (Bernstein, "To Your Health," Washington Post, 3/26; Firger, CBS News, 3/26; Hudson, CNN, 3/26; Tavernise, New York Times, 3/26; Emery, Reuters, 3/26).
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