Hospital infections a major problem

(Editor's note: The following information is summarized from a handout recently distributed by the Centers for Disease Control and Prevention in Atlanta at the first International Conference on Emerging Infectious Diseases. The material, which may be particularly useful in patient and public education programs, also includes updated CDC estimates on the national impact of nosocomial infections.)

What is a hospital-acquired infection?

This is any infection that a patient acquires as a result of receiving care in a hospital. Hospital-acquired infections are a major public health problem in the United States. These infections account for millions of illnesses and tens of thousands of deaths every year. Every patient receiving medical care is at risk for acquiring one of these infections. Generally, hospital-acquired infections occur when a bacteria or virus gets into a patient's body while the patient is receiving treatment for an illness or injury. For example, bacteria that reside normally on a patient's skin may enter the body via a tube that has been inserted into the patient's arm to administer antibiotics during an operation. Harmless on the skin, the bacteria may be deadly once inside the body. CDC's hospital infections program is working with other major health care organizations to protect patients from these infections.

What is the magnitude of the hospital-acquired infections problem in the United States, in illness, death, and costs?

Nearly 2 million people in the United States get hospital-acquired infections annually and nearly 90,000 of them die as a result. Hospital-acquired infections cost an estimated $4.5 billion yearly.

What are the most common infections acquired in health care settings? Which are the most life-threatening?

Urinary tract infections (566,000 annually), surgical wound infections (293,000 annually), pneumonia (274,000 annually), and bloodstream infections (236,000 annually) are the most common hospital-acquired infections. Of these, pneumonia (34,000 deaths annually) and bloodstream infections (25,000 deaths annually) cause the most deaths. Surgical wound infections (11,000 deaths annually) and urinary tract infections (9,000 deaths annually) also can be life-threatening.

Who is most at risk for these infections?

Patients who are very ill or who are undergoing invasive procedures are most at risk for hospital-acquired infections. There is no geographic concentration of these infections.

What should patients do or look for when they go into a hospital to lessen the risk of a hospital-acquired infection?

Patients should let their doctors and nurses know that they are concerned about hospital-acquired infections. This reminder will reinforce the infection control training and education of the health care workers. Further, because many hospital-acquired infections are transmitted on the hands of health care workers, patients and their family members can ask their health care workers to be sure to follow good hand-washing practices.

To whom should patients report questions or concerns about their care?

They should first report their concern to the physicians and nurses who are providing the care. If that does not resolve the concern, most hospitals have a patient advocate or ombudsman that patients can talk to. Hospital administrators also can be contacted. All states have licensing and oversight bodies in their state health departments that respond to concerns and complaints brought by patients.

What can health care providers do to lessen these infections?

CDC and other health care organizations have produced guidelines and recommendations to help hospitals, doctors, and other health care professionals minimize the risk of hospital-acquired infections. These guidelines and recommendations cover a broad range of issues, including hand-washing practices, the use of intravenous lines and other medical devices, and the proper use and administration of antibiotics. Health care workers can lessen infections by following these guidelines and recommendations.

What can patients and their visitors do to lessen these infections?

Provide a complete health history. Tell the health care provider about medications they take, especially antibiotics (some drugs/medications may increase the risk for an infection, e.g., patients taking antacids may be at increased risk for hospital-acquired pneumonia). Report infections that can spread to others, such as measles or varicella. Report recent exposures to people or animals who might have infectious diseases. Report travel to areas with high rates of infectious diseases, such as developing countries. Any or all of this information could alert a doctor or nurse to take special measures to prevent the spread of disease.

If I've recently been released from the hospital, what should I be on the lookout for regarding a hospital-acquired infection?

Consult with your health care provider if you've become more ill after arriving home and develop symptoms such as unexpected pain, chills, and/or fever; a discharge or increased inflammation of a surgical wound; or any other symptoms that your doctor did not tell you to anticipate.