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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

CDC national infection report: Progress and peril

On any given day in hospitals throughout the nation approximately one of every 25 patients has an infection they acquired after admission. Some 75,000 patients die of these health care associated infections (HAIs) annually. And that, my friends, is progress. It wasn’t that long ago we were talking about 1 of every 20 patients infected and some 100,000 annual HAI deaths.

Another less tangible point is the growing perception that these patients are not the result of some inevitable circumstance, like unavoidable even “expected” casualties lying in the field of battle. No, these patients are people with families who entered the health care system in good faith. The system failed them despite the heroic efforts of health care workers in many cases. In others, providers inadvertently planted the seed of an HAI by going from patient to patient without washing their hands or changing gloves. But there is progress, or better stated, national HAI reduction is a work in progress.

“Most infections are decreasing,” the Centers for Disease Control and Prevention reports. “Despite this progress, the nation did not reach the 2013 goals established by the [HHS] HAI Action Plan in 2009, and catheter-associated urinary tract infections (CAUTIs) have increased since 2009.”

On the other hand, there has been a 46% decrease in central line-associated bloodstream infections (CLABSIs) between 2008 and 2013, the CDC noted. The annual National and State Healthcare-associated Infection Progress Report also provides a snapshot of how individual states are doing on HAIs that hospitals are required to report to the CDC national surveillance system. Among the 50 states, Washington, D.C., and Puerto Rico, 26 performed better than the rest of nation on at least two of the six infection types tracked by states (CLABSI, CAUTI, MRSA, Clostridium difficile, and surgical site infections [after colon surgery and abdominal hysterectomy]). Sixteen states performed better than the nation on three or more infections, including six states performing better on four infections. However, 19 states performed worse than the nation on two infections, while eight states suffered by comparison on at least three infections.

For the first time, the HAI progress report includes state-specific data about hospital lab-identified methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and C. diff infections. The latter has been particularly difficult to reduce, but the CDC reported a 10% decrease in C. diff infections in acute care hospitals between 2011 and 2013. That said, as care moves beyond the hospital C. diff and other HAIs are going right along with it.

“The majority of C. difficile infections and MRSA infections develop in the community or are diagnosed in health care settings other than hospitals,” the CDC noted. “Other recent reports on infections caused by MRSA and C. difficile suggest that infections in hospitalized patients only account for about one-third of all the healthcare-associated infections.”