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Abstract contributed by Sherri Besmer, MD, pediatric pathology fellow, Children’s Hospital of Philadelphia.

Changes in prevalence of health care-associated infections in U.S. hospitals

Health care-associated infections are a major risk factor for patients in U.S. hospitals. The rates of hospital-associated infections are national metrics that are used by governmental agencies and consumer-related groups to assess health care quality in hospitals. The National Healthcare Safety Network of the Centers for Disease Control and Prevention tracks state and national data on the prevention of health care-associated infections in thousands of U.S. health care facilities. Point-prevalence surveys complement the network’s location- and infection-specific data and allow public officials and health care leaders to periodically assess health care-associated infections for future consideration of tracking and prevention. A point-prevalence survey performed in 2011 showed that four percent of patients had a health care-associated infection. The authors, all investigators for the CDC’s Emerging Infections Program Hospital Prevalence Survey Team, repeated the survey in 2015 to assess changes in the prevalence of health care-associated infections. They recruited up to 25 hospitals in Emerging Infections Program site areas in 10 states, prioritizing hospitals that participated in the 2011 survey. Each hospital selected one day to randomly sample patients identified for assessment. Trained staff then compared the percentages of patients with health care-associated infection and performed multivariable log-binomial regression modeling to evaluate the association of survey year with the risk of health care-associated infection. In 2015, 12,299 patients in 199 hospitals were surveyed, compared with 1,282 patients in 183 hospitals in 2011. Patients’ risk of having a health care-associated infection was 16 percent lower in 2015 than in 2011, largely due to reductions in the prevalence of surgical-site and urinary tract infections. These results were statistically significant. The most common health care-associated infections identified in the survey were pneumonia; gastrointestinal infections, primarily due to Clostridium difficile; and surgical-site infections. The authors concluded that, in accordance with their findings, strategies to further reduce infections should focus on the prevention of C. difficile and pneumonia.

Magill SS, O’Leary E, Janelle SJ, et al. Changes in prevalence of health care-associated infections in U.S. hospitals. N Engl J Med. 2018;379​(18):1732–1744.

Correspondence: Dr. Shelley S. Magill at smagill@​cdc.gov