scholarly journals 172. Impact of COVID-19 Pandemic on Healthcare-associated Infections (HAIs) in a Large Network of Hospitals

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S103-S104
Author(s):  
Sonali D Advani ◽  
Sonali D Advani ◽  
Emily Sickbert-Bennett ◽  
Elizabeth Dodds Ashley ◽  
Andrea Cromer ◽  
...  
Keyword(s):  
Regression Model ◽  
Baseline Period ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Large Network ◽  
Segmented Regression ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact ◽  
Segmented Regression Model

Abstract Background The COVID-19 pandemic had a considerable impact on US healthcare systems, straining hospital resources, staff, and operations. Our objective was to evaluate the impact of COVID-19 pandemic on incidence and trends of healthcare-associated infections (HAIs) in a network of hospitals. Methods This was a retrospective review of central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), C. difficile infections (CDI), and ventilator-associated events (VAE) in 51 hospitals from 2018 to 2021. Descriptive statistics were reported as mean hospital-level monthly incidence rates (IR) and compared using Poisson regression GEE models with period as the only covariate. Segmented regression (SR) analysis was performed to estimate changes in monthly IR of CAUTIs, CLABSIs and CDI in the baseline period (01/2018 – 02/2020) and the Pandemic period (03/2020 – 03/2021). SR model was not appropriate for VAE based on the plot. All models were constructed using SAS v.9.4 (SAS Institute, Cary NC). Results Compared to the baseline period, CLABSIs increased significantly by 50% from 0.6 to 0.9/ 1000 catheter days (P< 0. 001). In contrast, no significant changes were identified for CAUTI (P=0.87). Similar trends were seen in SR models for CLABSI and CAUTI (Figures 1, 2 and Table 1). While overall CDIs decreased significantly from 3.5 to 2.5/10,000 patient days in the pandemic period (P< 0.001), SR model showed increasing pandemic trend change (Figure 3). VAEs increased > 700% from 6.9 to 59.7/1000 ventilator days (P=0.15), but displayed considerable variation during the pandemic period (Figure 4). Compared to baseline period, there was a significant increase in central line days (647 vs 677, P=0.02), ventilator days (156 vs 215, P< 0.001), but no change in urinary catheter days (675 vs 686, P=0.32) during the pandemic period. Figure 1: Segmented Regression model showing baseline and pandemic period trends of CLABSI Figure 2: Segmented Regression model showing baseline and pandemic period trends of CAUTI Figure 3: Segmented Regression model showing baseline and pandemic period trends of C. difficile (HO-CDI) infections Conclusion The COVID-19 pandemic was associated with substantial increases in CLABSIs and VAEs, no change in CAUTIs, and an increasing trend in CDI incidence. These variations in trends of different HAIs are likely due, in part, to unique characteristics of the underlying infection, resource shortages, staffing concerns, increased device use, changes in testing practices, and the limitations of surveillance definitions. Figure 4: Trend of Ventilator-Associated Events (VAE) in the baseline and pandemic period (Segmented Regression model not appropriate) Disclosures Sonali D. Advani, MBBS, MPH, Nothing to disclose David J. Weber, MD, MPH, Merck (Individual(s) Involved: Self): Consultant; PDI (Individual(s) Involved: Self): Consultant; Pfizer (Individual(s) Involved: Self): Consultant; Sanofi (Individual(s) Involved: Self): Consultant; UVinnovators (Individual(s) Involved: Self): Consultant

scholarly journals 593. Burden of Healthcare-Associated Infections among Hospitalized Infants within Community Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S279-S280
Author(s):  
Ibukunoluwa C Akinboyo ◽  
Rebecca R Young ◽  
Michael J Smith ◽  
Becky A Smith ◽  
Sarah S Lewis ◽  
...  
Keyword(s):  
Infection Control ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Control Network ◽  
Healthcare Associated Infections ◽  
Community Hospitals ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background Healthcare-associated infections (HAI) remain the leading cause of morbidity and mortality among hospitalized children. Within community hospitals with targeted infection prevention efforts, participation in an infection control network has led to significant decreases in device or procedure-related infections among adult patients. The impact of these interventions has not been assessed in pediatric patients admitted to community hospitals. Methods We conducted a retrospective cohort study to describe the burden of HAI among hospitalized infants (< 1 year old) within 53 community hospitals participating in the Duke Infection Control Outreach Network (DICON) from 2013–2018. We determined the frequency of device-related HAI, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and hospital-associated pneumonia or ventilator-associated events (HAP/VAE) using National Healthcare Safety Network (NHSN) definitions; and the burden of HAIs among neonatal intensive care units (NICU) and non-NICU centers. The trend of HAI was analyzed with Spearman’s correlation. Results Thirty hospitals reported 150 HAI among 141 infants over the 6-year period. Median (IQR) time to infection was 10 (4, 20) days after admission. Hospitals with a NICU (15) reported more HAI (median 5, (IQR: 3, 12)) than hospitals without a NICU (median 2 (IQR: 1, 2)) (P = 0.031). CLABSI represented 35% of HAI, HAP/VAE were 23% and CAUTI were 12%. The most frequently isolated primary organism for all HAI was Escherichia coli (22 HAI, 15%) which was also isolated in 39% of CAUTI. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (S. aureus) were the most commonly isolated organisms among CLABSI (17%) and HAP/VAE (33%). Nine centers with ≥4 years of NICU and Central line (CL) use data reported a median (IQR) rate of 1.2 (0, 2.4) CLABSIs/1,000 central line days. There was no change in median CLABSI rate over time (P = 0.47), Figure 1. Conclusion CLABSI, most commonly caused by S. aureus, represented the majority of HAI reported from hospitalized infants within community hospitals participating in an infection control network. Further research into device utilization practices may inform future interventions to reduce HAI. Disclosures All authors: No reported disclosures.

scholarly journals Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

2021 ◽  
Vol 9 (11) ◽  
pp. 2332
Author(s):  
Nitin Chandra Teja Dadi ◽  
Barbora Radochová ◽  
Jarmila Vargová ◽  
Helena Bujdáková
Keyword(s):  
Medical Devices ◽  
Surgical Site Infections ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Care Bundles ◽  
Planktonic Form ◽  
Novel Approaches ◽  
Healthcare Associated ◽  
The Impact

Healthcare-associated infections (HAIs) are caused by nosocomial pathogens. HAIs have an immense impact not only on developing countries but also on highly developed parts of world. They are predominantly device-associated infections that are caused by the planktonic form of microorganisms as well as those organized in biofilms. This review elucidates the impact of HAIs, focusing on device-associated infections such as central line-associated bloodstream infection including catheter infection, catheter-associated urinary tract infection, ventilator-associated pneumonia, and surgical site infections. The most relevant microorganisms are mentioned in terms of their frequency of infection on medical devices. Standard care bundles, conventional therapy, and novel approaches against device-associated infections are briefly mentioned as well. This review concisely summarizes relevant and up-to-date information on HAIs and HAI-associated microorganisms and also provides a description of several useful approaches for tackling HAIs.

Costs of ambulatory pediatric healthcare-associated infections: Central-line–associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs)

2020 ◽  
Vol 41 (11) ◽  
pp. 1292-1297
Author(s):  
Michael L. Rinke ◽  
Suzette O. Oyeku ◽  
William J. H. Ford ◽  
Moonseong Heo ◽  
Lisa Saiman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Ambulatory Surgery ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Retrospective Case ◽  
Additional Costs ◽  
Tract Infections ◽  
Healthcare Associated

AbstractObjective:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery.Design:Retrospective case-control study.Setting:Four academic medical centers.Patients:Children aged 0–22 years seen between 2010 and 2015 and at risk for HAI as identified by electronic queries.Methods:Chart review adjudicated HAIs. Charges were obtained for patients with HAIs and matched controls 30 days before HAI, on the day of, and 30 days after HAI. Charges were converted to costs and 2015 USD. Mixed-effects linear regression was used to estimate the difference-in-differences of HAI case versus control costs in 2 models: unrecorded charge values considered missing and a sensitivity analysis with unrecorded charge considered $0.Results:Our search identified 177 patients with ambulatory CLABSIs, 53 with ambulatory CAUTIs, and 26 with SSIs following ambulatory surgery who were matched with 382, 110, and 75 controls, respectively. Additional cost associated with an ambulatory CLABSI was $5,684 (95% confidence interval [CI], $1,005–$10,362) and $6,502 (95% CI, $2,261–$10,744) in the 2 models; cost associated with a CAUTI was $6,660 (95% CI, $1,055, $12,145) and $2,661 (95% CI, −$431 to $5,753); cost associated with an SSI following ambulatory surgery at 1 institution only was $6,370 (95% CI, $4,022–$8,719).Conclusions:Ambulatory HAI in pediatric patients are associated with significant additional costs. Further work is needed to reduce ambulatory HAIs.

Infections in Australian Aged-Care Facilities: Evaluating the Impact of Revised McGeer Criteria for Surveillance of Urinary Tract Infections

2016 ◽  
Vol 37 (5) ◽  
pp. 610-612 ◽  
Author(s):  
Noleen J. Bennett ◽  
Sandra A. Johnson ◽  
Michael J. Richards ◽  
Mary A. Smith ◽  
Leon J. Worth
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Aged Care ◽  
Infect Control Hosp ◽  
Healthcare Associated Infections ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Our survey of 112 Australian aged-care facilities demonstrated the prevalence of healthcare-associated infections to be 2.9%. Urinary tract infections (UTIs) defined by McGeer criteria comprised 35% of all clinically defined UTIs. To estimate the infection burden in these facilities where microbiologic testing is not routine, modified surveillance criteria for UTIs are necessary.Infect Control Hosp Epidemiol 2016;37:610–612

scholarly journals Frequency of Healthcare-Associated Infections in the Elderly Patient Hospitalized

2021 ◽  
Author(s):  
Aria Rahmani ◽  
Alireza Namazi Shabestari ◽  
Maryam Sadeh ◽  
Reza Bidaki ◽  
Saeidreza Jamalimoghadamsiahkli ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Hospital Stay ◽  
Urinary Tract Infections ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated

Introduction: Healthcare- Associated Infections (HAI) are known to be one of the most important health issues in developed and developing countries. The most common infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia and surgical site infection. The aim of this study was to investigate the incidence of nosocomial infections in the elderly patients. Methods: In this cross-sectional study, 1279 patients were 60 years of age or older. Patients who had been admitted for more than 48 hours in the hospital and had no signs of infection at the time of admission, were entered into the study. It was evaluated four most common HAI, according to CDC include bacteremia, central line-associated blood stream infections, urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgery sites, known as surgical site infections. The Chi-square and T- test or analysis of variance was used for data analysis. Results: Of the total patients, 93 (7.3%) developed HAI at duration admission. The highest rate of infection was bacteremia, which was 48.4 % and then urinary tract infection 21.5%. The prevalence of HAI among patients with cardiovascular diseases was relatively higher than underlying diseases. The frequency of length of hospital stay was significant in patients > 7 days with 68.8% in the HAI group. Conclusion: Our findings showed that patients with cardiovascular, renal and pulmonary disease are more susceptible to HAIs. Due to the increased length of hospital stay increases the risk of infection, it is recommended to discharge patients as soon as possible.

scholarly journals The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
V. Baccolini ◽  
G. Migliara ◽  
C. Isonne ◽  
B. Dorelli ◽  
L. C. Barone ◽  
...  
Keyword(s):  
Intensive Care ◽  
Regression Models ◽  
Multivariable Analysis ◽  
Control Measures ◽  
Healthcare Associated Infections ◽  
Risk Of Death ◽  
Infection Control Measures ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background During the intensive care units’ (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients. Methods Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey’s regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort. Results Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31–5.38, and SHR: 10.0, 95% CI 1.84–54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections. Conclusions We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.

Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections

2021 ◽  
pp. 1-6
Author(s):  
Sarah R. MacEwan ◽  
Eliza W. Beal ◽  
Alice A. Gaughan ◽  
Cynthia Sieck ◽  
Ann Scheck McAlearney
Keyword(s):  
Patient Education ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Central Lines ◽  
Challenges And Opportunities ◽  
Hospital Leaders ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Objective: Device-related healthcare-associated infections (HAIs), such as catheter-associated urinary tract infections (CAUTIs) and central-line–associated bloodstream infections (CLABSIs), are largely preventable. However, there is little evidence of standardized approaches to educate patients about how they can help prevent these infections. We examined the perspectives of hospital leaders and staff about patient education for CAUTI and CLABSI prevention to understand the challenges to patient education and the opportunities for improvement. Methods: In total, 471 interviews were conducted with key informants across 18 hospitals. Interviews were analyzed deductively and inductively to identify themes around the topic of patient education for infection prevention. Results: Participants identified patient education topics specific to CAUTI and CLABSI prevention, including the risks of indwelling urinary catheters and central lines, the necessity of hand hygiene, the importance of maintenance care, and the support to speak up. Challenges, such as lack of standardized education, and opportunities, such as involvement of patient and family advisory groups, were also identified regarding patient education for CAUTI and CLABSI prevention. Conclusions: Hospital leaders and staff identified patient education topics, and ways to deliver this information, that were important in the prevention of CAUTIs and CLABSIs. By identifying both challenges and opportunities related to patient education, our results provide guidance on how patient education for infection prevention can be further improved. Future work should evaluate the implementation of standardized approaches to patient education to better understand the potential impact of these strategies on the reduction of HAIs.

Healthcare-associated infections in the postoperative period after cardiac surgery

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Edivete Regina Andrioli ◽  
Rubens Andrioli Cavalheiro ◽  
Guilherme Campos Furtado ◽  
Walter José Gomes ◽  
Eduardo Alexandrino Medeiros
Keyword(s):  
Cardiac Surgery ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Independent Variables ◽  
Tract Infections ◽  
Healthcare Associated

Background: This study aimed to determine the incidence of healthcare-associated infections (HAIs) in patients undergoing cardiac surgery, analyzing data and clinical outcomes in patients with and without HAIs. Methods: This was a prospective cohort study involving 293 consecutive adult patients undergoing cardiac surgery between April 2011 and October 2012. Results: Of the 293 patients, 60 (24.9%) developed 73 HAIs: 24 surgical site infections, 24 pneumonias, 14 urinary tract infections (UTIs), and 11 bloodstream infections (BSIs). The incidence of ventilator-associated pneumonia was 14.6 cases/1,000 ventilator-days, whereas that of catheter-associated UTI was 7.15 cases/1,000 catheter-days and that of central line-associated BSI was 4.52 cases/1,000 central line-days. Of the 60 patients with HAIs, 20 (33%) died before postoperative day 90, compared with 18 (7.7%) of the 233 patients without HAIs (P < .001). Independent variables associated with infection were length of hospital stay (OR, 1.04; 95% CI, 1.01-1.06; P = .002), duration of urinary catheter use (OR, 1.19; 95% CI, 1.07-1.13; P = .001), and duration of central line use (OR, 1.07; 95% CI, 1.01-1.13; P = .032). Independent variables associated with mortality were Acute Physiology and Chronic Health Evaluation II score (OR, 1.27; 95% CI 1.14-1.42; P < .001), pneumonia (OR, 11.94; 95% CI, 3.83-37.17; P < .001), UTI (OR, 8.59; 95% CI, 1.91-38.7; P = .005), and BSI (OR, 6.16; 95% CI, 1.08-34.98; P = .040). Conclusion: Among the most important complications after cardiac surgery are HAIs. Patients who experience postoperative infections have increased length of hospital stay and mortality.

scholarly journals 171. The Impact of COVID-19 on Healthcare-Associated Infections

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Meghan A Baker ◽  
Kenneth Sands ◽  
Susan S Huang ◽  
Ken Kleinman ◽  
Edward Septimus ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Negative Binomial ◽  
Bloodstream Infections ◽  
Local Variation ◽  
Healthcare Associated Infections ◽  
Material Support ◽  
Cleaning Products ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). Objective Evaluate the association between COVID-19 surges and HAI or cluster rates Methods Design: Prospective cohort study Setting 148 HCA Healthcare-affiliated hospitals, 3/1/2020-9/30/2020, and a subset of hospitals with microbiology and cluster data through 12/31/2020 Patients All inpatients Measurements We evaluated the association between COVID-19 surges and HAIs, hospital-onset pathogens, and cluster rates using negative binomial mixed models. To account for local variation in COVID-19 pandemic surge timing, we included the number of discharges with a laboratory-confirmed COVID-19 diagnosis per staffed bed per month at each hospital. Results Central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia increased as COVID-19 burden increased (P ≤ 0.001 for all), with 60% (95% CI, 23 to 108%) more CLABSI, 43% (95% CI, 8 to 90%) more CAUTI, and 44% (95% CI, 10 to 88%) more cases of MRSA bacteremia than expected over 7 months based on predicted HAIs had there not been COVID-19 cases. Clostridioides difficile infection (CDI) was not significantly associated with COVID-19 burden. Microbiology data from 81 of the hospitals corroborated the findings. Notably, rates of hospital-onset bloodstream infections and multidrug resistant organisms, including MRSA, vancomycin-resistant enterococcus and Gram-negative organisms were each significantly associated with COVID-19 surges (P &lt; 0.05 for all). Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased (P = 0.02). Limitations Variations in surveillance and reporting may affect HAI data. Table 1. Effect of an increase in number of COVID-19 discharges on HAIs and hospital-onset pathogens Figure 1. Predicted mean HAI rates as COVID-19 discharges increase Predicted mean HAI rate by increasing monthly COVID-19 discharges. Panel a. CLABSI, Panel b, CAUTI Panel c. MRSA Bacteremia, Panel d. CDI. Data are stratified by small, medium and large hospitals. Figure 2. Monthly comparison of COVID discharges to clusters COVID-19 discharges and the number of clusters of hospital-onset pathogens are correlated throughout the pandemic. Conclusion COVID-19 surges adversely impact HAI rates and clusters of infections within hospitals, emphasizing the need for balancing COVID-related demands with routine hospital infection prevention. Disclosures Kenneth Sands, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Ken Kleinman, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Edward Septimus, MD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Eunice J. Blanchard, MSN RN, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Russell Poland, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Micaela H. Coady, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Deborah S. Yokoe, MD, MPH, Nothing to disclose Julia Moody, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Richard Platt, MD, MSc, Medline (Research Grant or Support, Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Jonathan B. Perlin, MD, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)

The Network Approach for Prevention of Healthcare-Associated Infections: Long-Term Effect of Participation in the Duke Infection Control Outreach Network

2011 ◽  
Vol 32 (4) ◽  
pp. 315-322 ◽  
Author(s):  
Deverick J. Anderson ◽  
Becky A. Miller ◽  
Luke F. Chen ◽  
Linda H. Adcock ◽  
Evelyn Cook ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Rates ◽  
Healthcare Associated Infections ◽  
Bloodborne Pathogens ◽  
Average Decrease ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe the rates of several key outcomes and healthcare-associated infections (HAIs) among hospitals that participated in the Duke Infection Control Outreach Network (DICON).Design and Setting.Prospective, observational cohort study of patients admitted to 24 community hospitals from 2003 through 2009.Methods.The following data were collected and analyzed: incidence of central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTIs), and HAIs caused by methicillin-resistant Staphylococcus aureus (MRSA); employee exposures to bloodborne pathogens (EBBPs); physician EBBPs; patient-days; central line-days; ventilator-days; and urinary catheter-days. Poisson regression was used to determine whether incidence rates of these HAIs and exposures changed during the first 5 and 7 years of participation in DICON; nonrandom clustering of each outcome was controlled for. Cost saved and lives saved were calculated on the basis of published estimates.Results.In total, we analyzed 6.5 million patient-days, 4,783 EBPPs, 2,948 HAIs due to MRSA, and 2,076 device-related infections. Rates of employee EBBPs, HAIs due to MRSA, and device-related infections decreased significantly during the first 5 years of participation in DICON (P < .05 for all models; average decrease was approximately 50%); in contrast, physician EBBPs remained unchanged. In aggregate, 210 CLABSIs, 312 cases of VAP, 332 CAUTIs, 1,042 HAIs due to MRSA, and 1,016 employee EBBPs were prevented. Each hospital saved approximately $100,000 per year of participation, and collectively the hospitals may have prevented 52-105 deaths from CLABSI or VAP. The 7-year analysis demonstrated that these trends continued with further participation.Conclusions.Hospitals with long-term participation in an infection control network decreased rates of significant HAIs by approximately 50%, decreased costs, and saved lives.

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