Hospital Infection Prevention-CDC home care survey finds 16% infections

But only 8% acquired via home care

Highlights of a survey of infections in home care conducted by the Centers for Disease Control and Prevention and the Missouri Alli ance for Home Care included findings summarized as follows:

During June 1-30, 1999, home care nurses in 73 Missouri home care agencies completed questionnaires on 5,148 patients. Of those patients, 793 (16%) were reported to have infections.

Of the infections, 8% were reported as home care-acquired, 16% as hospital-acquired, and the remainder as community-acquired (41%) or unknown (35%). Overall, 90% were treated with antimicrobials, including 4% treated with vancomycin.

The most common infection sites were the urinary tract (27%), respiratory tract (24%), skin/soft tissue (24%), surgical site (12%), or bloodstream (2%). Another 18% of infections occurred at other body sites (e.g., gastrointestinal tract, bone).

Invasive medical devices were present in 1,729 (34%) of surveyed patients. Of those, 21% had a urethral or suprapubic catheter; 17% a central venous catheter; 14% another device (e.g., wound drainage tube, tracheostomy or nephrostomy tube, or implanted device); 7% a gastrostomy tube; and 1% a mechanical ventilator. Use of a urethral or suprapubic catheter was associated with a higher risk of urinary tract infection (76/297 vs. 138/4,637). Use of a central catheter was associated with a higher risk of bloodstream infection (6/283 vs. 9/4,850). Venti lator use (1/10 vs. 186/4,951) was not associa ted with respiratory tract infection.

Reference

1. Manangan LP, Schantz M, Pearson MI, et al. Prevalence of infections among patients in home care. Abstract PM1-27. Presented at the Centers for Disease Control and Prevention 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infection. Atlanta; March 5-9, 2000.