March 27, 2014
About one in 25 hospital patients in the U.S. pick up an infection during their care, according to a new estimate from the federal Centers for Disease Control and Prevention (CDC).
Such infections are preventable but still happen 721,800 times a year, affecting 648,000 patients, say CDC researchers reporting Wednesday in the New England Journal of Medicine. About 11% of those patients die.
The report, based on a survey conducted in 183 hospitals in 10 states in 2011, updates a previous estimate of 1.7 million infections a year. That estimate, issued in 2007, was based on different study methods, so the numbers can't be directly compared, officials say.
"But the trend looks like there are fewer infections," than in the past, says Michael Bell, deputy director of the CDC's division of healthcare quality promotion. "It makes sense because of all the efforts we've made to reduce infections."
A second report out from the CDC on Wednesday shows where progress is and is not being made. CDC says infections related to 10 common surgeries declined 20% from 2008 to 2012. During the same period, the CDC recorded a 44% decline in infections related to central lines, tubes placed in the chest, arm or neck to deliver nutrients and medicine and make blood draws easier. But infections related to urinary catheters rose 4%.
The report, based on data healthcare facilities must provide to the CDC, also shows limited progress in controlling some particularly worrisome bugs, including the diarrhea-causing bacterium Clostridium difficile. C. diff spores can linger on bed rails, linens, medical equipment and hands, allowing the infection to spread through hospitals, person to person. It most often takes hold in people taking antibiotics.
"We are seeing 250,000 cases and 14,000 deaths each year from C. diff and those deaths should really be preventable," Bell says. "There's a sense of urgency."
In a statement, CDC director Tom Frieden said: "Although there has been some progress, today and every day, more than 200 Americans with healthcare-associated infections will die during their hospital stay. The most advanced medical care won't work if clinicians don't prevent infections through basic things such as regular hand hygiene."
Hospitals are working hard to improve hand washing, curb unneeded antibiotic use and to take other steps to prevent infections, says Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association.
"There are hundreds, if not thousands of people alive today because of the work that's already been done," she says. But she agrees there's more to do. "C. diff has risen to the top of the pile of things we need to tackle," she says.
The new reports show "we are moving in the right direction," says Lisa Maragakis, director of infection control at the Johns Hopkins Hospital, Baltimore. Maragakis is helping to compile updated strategies for healthcare workers for the Infectious Disease Society of America.
"Healthcare providers and hospitals take these problems seriously," she says. The need to report such infections is increasing accountability, she says.
Patients can also take steps to protect themselves, the experts say. For example, patients and families can ask health workers to wash hands, ask when catheters and other tubes can be removed and ask whether any antibiotics prescribed are truly needed and appropriate.
Asking such questions is not easy for many people, Bell says. "My own mother was in the intensive care unit and I found it hard to pipe up. ... It's hard to do, but it's very important that people try."
Patients and families also can check on the infection control records of their hospitals at Hospital Compare, a site maintained by Medicare.
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