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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
Amid all the numbers, estimates and extrapolations in recently released new data on health care associated infections, one particular HAI identified in a point prevalence study jumped out at epidemiologists and infection preventionists: non–ventilator-associated pneumonia.
“We were really surprised where pneumonia was – accounting for nearly 22% of all HAIs,” says Marion Kainer, MD, co-author of the point prevalence study.1 “It is very common and a lot of it is not ventilator associated. There is a lot of morbidity and mortality associated with it. We really don’t fully understand the epidemiology of what is causing this."
In general the point prevalence survey of 183 hospitals picked up a lot of HAIs that were not device related, underscoring the need to fight more infections beyond the ICU, said Kainer, director of the Healthcare Associated Infections & Antimicrobial Resistance Program at the Tennessee Department of Health in Nashville.
While there were other findings of significance, the level of pneumonia infections in non-ventilated patients was the subject of much discussion and speculation.
“We need to think about how to capture pneumonia that is not ventilator associated,” she said. “How do you do surveillance for that and what is the true epidemiology? Are these post procedural and people are not getting adequate pain relief? Are they not moving their diaphragms, not being mobilized enough and being sedated too much? We need to [determine] what is causing these.”
1. Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014; 370:1198-1208
For much more on this story see the May 2014 issue of Hospital Infection Control & Prevention