Twenty-one states posted decreases in central line-associated bloodstream infections (CLABSI) in 2010, according to a report from the Centers for Disease Control and Prevention. This translates to a 32% national reduction, which suggests that the national goal of reducing CLABSI by 50% by 2013 is within reach.
California, Massachusetts, Oregon, and Virginia are among the states posting CLABSI decreases. Only Arizona and Delaware reported increases between 2009 and 2010, while 20 states reported no change, including Indiana, New Hampshire, and Vermont. Seven states, including Alaska and Idaho, didn’t file a report.
Data was reported from January through December 2010; the referent period is January 2006 through December 2008. In all, 22 states and the District of Columbia require the use of the National Healthcare Safety Network, CDC’s healthcare infection monitoring system, for HAI reporting mandates.
A Landmark Report
This is the first time the CDC has released a state level standardized infection ratio for CLABSI from all 50 states, as well as Puerto Rico and the District of Columbia. The data were submitted by more than 2,400 healthcare facilities to the NHSN.
According to the National and State Healthcare-Associated Infections Standardized Infection Ratio Report, 13,812 CLABSIs were reported compared to 20,184 predicted in 2010. This translates into a standard infection rate (SIR) of 0.684. When stratified by patient care groupings, SIRs were lowest among non-neonatal critical care locations (0.654), followed by NICUs (0.695) and wards (0.728).
The report also includes a national snapshot of the CLABSI infection risk linked to 10 common surgical procedures, including hip and knee arthroplasty, colon surgery, rectal surgery, coronary artery bypass graft, and abdominal hysterectomy. Only coronary artery bypass graft and rectal surgery showed a decrease in infections between 2009 and 2010. The others remained unchanged.
CAUTI Rates Dip 3%
In addition to CLABSI data, the report includes first-time national data reported for catheter-associated urinary tract infections (CAUTIs) showing that for all patient areas (excluding NICUs) 9,995 CAUTIs were reported compared to 10,656 predicted for an SIR of 0.938.
For CAUTIs, the SIR was slightly higher for among critical care locations (0.967) compared to ward locations (0.903). This translates into a reduction in CAUTIs of about 3% (ICUs) to 10% (ward locations) since 2009. The findings are based on reports from 1,086 healthcare facilities in 47 states.
Surgical Site Infection Rates Down 8%
National surgical site infection (SSI) data is also reported. SIR is limited to SSIs classified as deep incisional or organ/space infection detected during admission or readmission to the same hospital where the procedure was performed.
Some 4,737 SSIs were reported from more than 529,000 procedures. More than 5,170 were predicted for an SIR of 0.916. This translates into n 8% reduction in the incidence of these SSIs. The findings are based on reports from 1,385 healthcare facilities in 45 states.
In a press release announcing the report's release, Thomas R. Frieden, MD, CDC director called for a "a comprehensive approach for tackling infections in the nation's healthcare facilities, as patients can seek care from a variety of locations and move between healthcare facilities."
Coincidently, HHS posted on line on Thursday for public comment an updated National Action Plan. The request for public comments will be published next week in the Federal Register.
In August 2011 the Department of Health and Human Services awarded a total of $9 million across all 50 states to boost HAI prevention efforts. The awards ranged from $23,239 for Wyoming to $782,173 for Michigan.
The funds are to help states coordinate their HAI activities, implement multi-facility and multi-disciplinary prevention efforts, improve monitoring of antimicrobial use and enhance HAI reporting.
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Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
