Healthcare-Associated Infections (HAI): The Perfect Storm has Arrived!

Rodney E. Rohde; Marilyn Felkner; Julie Reagan; Amber Hogan Mitchell; Pat Tille

doi:10.29074/ascls.29.1.28

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Rodney E. Rohde, PhD, MS, SV, SM (ASCP)^CM, MB^CM⇑
1. Clinical Laboratory Science Program, College of Health Professions, Texas State University, San Marcos, TX
Marilyn Felkner, DrPH, MT(ASCP)
1. Emerging and Acute Infectious Disease Branch (EAIDB), Infectious Disease Control Unit, Texas Department of State Health Services (DSHS), Austin, TX
Julie Reagan, PhD, JD, MPH
1. Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA
Amber Hogan Mitchell, DrPH, MPH, CPH
1. The International Safety Center, Apopka, FL
Pat Tille, PhD, MT(ASCP)
1. Medical Laboratory Science, College of Pharmacy, South Dakota State University, SD

Address for Correspondence: Rodney E. Rohde, PhD, MS, SV, SM (ASCP)^CM, MB^CM, Professor & Chair, CLS Program; Associate Dean for Research, Clinical Laboratory Science Program, College of Health Professions, Texas State University, 601 University Drive, San Marcos, TX 78666, 512-245-2562, 512-245-7860, rrohde{at}txstate.edu

Extract

INTRODUCTION On any given day approximately 1 of every 25 inpatients in U.S. acute care hospitals has at least one healthcare–associated infection (HAI), adding up to about 722,000 infections in 2011. Pneumonia and surgical-site infection are the most common infection types, and Clostridium difficile is the most common pathogen.¹

The CDC Multistate Point-Prevalence Survey of Healthcare-Associated Infections, published in the New England Journal of Medicine, used 2011 data from 183 U.S. hospitals to estimate the burden of a wide range of infections in hospital patients. That year, about 721,800 infections occurred in 648,000 hospital patients. About 75,000 patients with HAI died during their hospitalizations. The most common healthcare-associated infections were pneumonia (22%), surgical site infections (22%), gastrointestinal infections (17%), urinary tract infections (13%), and bloodstream infections (10%).

The most common germs causing HAI by rank were C. difficile (12%), Staphylococcus aureus, including Methicillin Resistant S. aureus (MRSA, 11%), Klebsiella (10%), E. coli (9%), Enterococcus (9%), and Pseudomonas (7%). Klebsiella and E. coli are members of the Enterobacteriaceae bacteria family, which has become increasingly resistant to last-resort antibiotics known as carbapenems, typically referred to as carbapenem resistant Enterobacteriaceae (CRE).¹

Practically, what this means is that over 200 patients will die the day you read this article and every day until the global community is able to address this healthcare crisis. If you do the simple math you will realize this results in about 4% of hospitalized patients who developed one or more HAI due to the care received in the hospital…

ABBREVIATIONS: CAUTI – Catheter-associated urinary tract infection, CDC – Centers for Disease Control and Prevention, CLABSI – Central line-associated blood stream infection, EVS – Environmental services, HAI – Healthcare-associated infections, HCW – Healthcare Worker, MRSA – Methicillin resistant Staphylococcus aureus, SSIs – Surgical site infections