MedicalResearch.com Interview with:
Dr. Shelley Magill, MD
Medical Officer and CDC lead
for the hospital HAI (hospital acquired infections) and antimicrobial use prevalence survey
MedicalResearch.com: What is the background for this study?
Response: The prevalence survey effort began in 2009. The goal was to obtain a snapshot of all healthcare-associated infections affecting hospital patients, not limited to those commonly reported to the National Healthcare Safety Network. We conducted our first full-scale hospital prevalence survey in 2011, in collaboration with the Emerging Infections Program, a network of 10 state health departments and academic and other partners. Data from that survey showed that about four percent of patients had a healthcare-associated infection—or, on any given day, about 1 in 25 patients. We repeated the survey in a similar group of hospitals in 2015 to see whether changes had occurred.
MedicalResearch.com: What are the main findings?
Response: In the 2015 survey, data showed that about 3.2% of patients had a healthcare-associated infection—or, on any given day, about 1 in 31 patients. This represented a significant reduction in the prevalence of these infections compared to 2011. We found that the most common types of healthcare-associated infections were similar to what we’d seen in the 2011 survey.
Pneumonia was the most common infection in the 2015 survey, followed by gastrointestinal infections and surgical-site infections. In the 2011 survey, the most common infections were pneumonia and surgical-site infections, followed by gastrointestinal infections. In both surveys, most of the gastrointestinal infections were C. diff infections—a type of potentially deadly diarrhea that is associated with antibiotic use. Notably, while we did see reductions in some types of healthcare-associated infections, such as surgical-site and urinary tract infections, we did not see reductions in pneumonia or in C. diff infections.
MedicalResearch.com: What should readers take away from your report?
Response: Prevalence surveys of healthcare-associated infections complement the information we get from reporting of healthcare-associated infections to the CDC’s National Healthcare Safety Network, and provide another approach to tracking progress in improving patient safety in U.S. healthcare facilities. The results of the 2015 survey, when compared with the 2011 survey, show that progress in reducing healthcare-associated infections is being made, particularly for certain types of infections.
For example, we found that fewer patients in the 2015 survey had urinary catheters in place on the day of the survey. In addition, we found that a lower percentage of patients had urinary tract infections, and particularly urinary tract infections associated with catheters. This suggests that efforts to improve the use of catheters in hospitals may be working, and leading to fewer infections that can harm hospitalized patients.
On the other hand, there is more work to be done, especially for those infection types where we did not see improvements—such as C. diff infections or pneumonia. Pneumonia in hospital patients is a challenge. It can be difficult to diagnose accurately, and it is also difficult to define in an objective and standardized way to allow for tracking across hospitals. We are continuing to work with partners to determine next steps for surveillance and for prevention. To prevent C. diff infections, continued focus on improving the way we use antibiotics is very important, as are infection control measures to prevent spread in healthcare facilities. Data from the National Healthcare Safety Network show that we are beginning to make progress in preventing C. diff infections in hospitals, but there is more work to do.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In addition to the information we gain about types of infections in hospitals that may need more attention going forward, we can also use prevalence surveys to identify opportunities for improving antibiotic use in hospitals. For the 2015 survey, the data collectors gathered a lot of information on the antibiotics prescribed for hospitalized patients. We are working with this information to describe the quality of hospital antibiotic prescribing in selected circumstances, such as community-acquired pneumonia. We can also use the prevalence survey approach to describe and estimate the number of infections occurring in other healthcare settings. A lot of healthcare in the United States occurs outside of short-stay acute care hospitals, and preventable infections occur in these settings, too. We are currently in the process of completing the first large-scale prevalence survey of healthcare-associated infections in U.S. nursing homes. This was also conducted in collaboration with the Emerging Infections Program. The results of this survey will provide much-needed information on the number and types of infections affecting nursing home residents, and will also provide information that can help identify opportunities to improve antibiotic use in nursing homes.
MedicalResearch.com: Is there anything else you would like to add?
Response: We want to thank all of the healthcare facilities and staff that have participated in the survey effort over the years. Without their interest and voluntary participation, we would not be able to conduct these important projects.
I have nothing to disclose.
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