Health care-associated infections in the USA

Abstract

Every day, roughly one in 25 patients in the USA contracts at least one infection during their hospital care—an alarming statistic that is unacceptable in view of the fact that health care-associated infections (HAIs) are mostly preventable. On Jan 14, 2015, the Centers for Disease Control and Prevention (CDC) published the National and State Healthcare-Associated Infections Progress Report that includes infection data from more than 14 500 hospitals and health-care facilities across the USA, showing the progress made and the improvements needed to eliminate HAIs on a state-by-state and national level.The report tracked six infection types—central line-associated bloodstream infections, surgical site infections, methicillin-resistant Staphylococcus aureus infections, catheter-associated urinary tract infections, and Clostridium difficile infections—in all 50 US states, the District of Columbia, and Puerto Rico. Nationally, the report shows encouraging progress, including a 46% reduction in central line-associated bloodstream infections and a 19% reduction in surgical site infections between 2008 and 2013, and an 8% decrease in methicillin-resistant S aureus bloodstream infections between 2011 and 2013. However, a 6% increase in catheter-associated urinary tract infections since 2009 was also reported, indicating that particular attention to catheter-associated urinary tract infections is needed in addition to continued prevention for other HAIs. The report also shows that some states had improvements and others had decreases in specific infection types compared with the nation. However, the reasons for differences between state infection rates are not mentioned and would be interesting to assess in the next CDC report—potentially paving the way for state-specific infection prevention measures.CDC data suggest that implementation of existing infection prevention strategies could lead to a US$25–31·5 billion saving in medical costs and a 70% reduction in HAIs. However, further prevention efforts are clearly needed—particularly, collaboration between hospitals, health-care facilities, and the US Federal Government to eliminate HAIs. Every day, roughly one in 25 patients in the USA contracts at least one infection during their hospital care—an alarming statistic that is unacceptable in view of the fact that health care-associated infections (HAIs) are mostly preventable. On Jan 14, 2015, the Centers for Disease Control and Prevention (CDC) published the National and State Healthcare-Associated Infections Progress Report that includes infection data from more than 14 500 hospitals and health-care facilities across the USA, showing the progress made and the improvements needed to eliminate HAIs on a state-by-state and national level. The report tracked six infection types—central line-associated bloodstream infections, surgical site infections, methicillin-resistant Staphylococcus aureus infections, catheter-associated urinary tract infections, and Clostridium difficile infections—in all 50 US states, the District of Columbia, and Puerto Rico. Nationally, the report shows encouraging progress, including a 46% reduction in central line-associated bloodstream infections and a 19% reduction in surgical site infections between 2008 and 2013, and an 8% decrease in methicillin-resistant S aureus bloodstream infections between 2011 and 2013. However, a 6% increase in catheter-associated urinary tract infections since 2009 was also reported, indicating that particular attention to catheter-associated urinary tract infections is needed in addition to continued prevention for other HAIs. The report also shows that some states had improvements and others had decreases in specific infection types compared with the nation. However, the reasons for differences between state infection rates are not mentioned and would be interesting to assess in the next CDC report—potentially paving the way for state-specific infection prevention measures. CDC data suggest that implementation of existing infection prevention strategies could lead to a US$25–31·5 billion saving in medical costs and a 70% reduction in HAIs. However, further prevention efforts are clearly needed—particularly, collaboration between hospitals, health-care facilities, and the US Federal Government to eliminate HAIs.