When it comes to hospital-acquired infections (HAIs), too many clinicians believe they’re already ahead of infection control challenges.
Some organizations question the need for an updated infection prevention and control (IPC) program, but that skepticism means that leaders act quickly is even more important. New threats are always emerging, and robust infection prevention programs help reduce the chance of HAI infection and improve outcomes for all your patients.
This is especially true for programs that address today’s most pressing infection challenges to reduce variability in care. To help more organizations implement this type of program, we’ve pulled together these five key points for today’s IPC leaders.
1. COVID-19 has hampered efforts to halt hospital-acquired infections
Prior to the COVID-19 pandemic, healthcare-associated infections had been decreasing since 2015, reports the Center for Infectious Disease Research and Policy (CIDRAP). However, the strain of COVID-19 patient care and triage on hospitals and other facilities “clearly put a dent in those efforts,” CIDRAP states.
During the last quarter of 2019 and second quarter of 2020, facilities were exempt from reporting HAIs. To gain insight into the impact of COVID-19 on hospital-acquired infections, the CDC’s National Healthcare Safety Network (NHSN) examined quarterly data from across 12 states. They found significant increases in central line associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAE), and MRSA bacteremia compared to 2019, including a 47% increase in CLABSIs across location types and a 65% increase in ICUs.
IPC programs have been overwhelmed by the pandemic, leaving many under-resourced and some pushing non-COVID HAIs onto the back burner. Hospitals need resilient, sustainable, and high-performing infection prevention and control programs more than ever.
2. These infections cost the healthcare system billions each year
According to the CDC, HAIs directly cost US hospitals at least $28.4 billion each year. These costs are underscored by a $12.4 billion loss to society from early deaths and lost productivity. Of the total amount, anywhere between $5.7 and $31.5 billion is possibly preventable.
The losses appear even more stark at the individual hospital level. A 2020 study published in BMC Health Services Research found that HAIs were associated with increased consumption of resources, including blood tests, imaging, hospital days, and antibiotic days. They were also associated with a higher cost per case at $6,400 vs. a control of $2,376.
3. Less than half of HAIs involve devices or surgeries
A study from the New England Journal of Medicine (NEJM) found that device-associated infections (such as CAUTI, ventilator-associated pneumonia, and CLABSI) made up 25.6% of all HAIs, while surgical-site infections accounted for 21.8% of HAIs. So, what caused the 52.6% of HAIs that were not associated with devices or operative procedures?
One pathogen stands out. The bacterium Clostridioides difficile accounts for 12.1% of HAIs, notes the NEJM study. C. difficile is easily spread from person to person and caused an estimated 223,900 HAI cases and 12,800 deaths in 2017, according to the CDC’s 2019 Antibiotic/Antimicrobial Resistance threat report.
C. difficile is resistant to multiple antibiotics used in clinical settings, including aminoglycosides, lincomycin, tetracyclines, erythromycin, clindamycin, penicillin, cephalosporins, and fluoroquinolones, according to research from the Journal of Clinical Microbiology. Treatment with antimicrobials significantly increases the risk of developing a C. difficile infection.
