美國院內感染率改善!!

Hospitals
Make Progress Toward Reducing Some Infections: CDC

Robert
Lowes

October 20, 2011 —
US hospitals in 2010 made impressive strides toward reducing the incidence of
central line–associated bloodstream infections and 3 other iatrogenic
infections, but not so for Clostridium difficile
infections, the US Centers for Disease Control and Prevention (CDC) announced
today.

The progress
report comes midway in a 5-year campaign that the Department of Health and
Human Services (HHS) launched in 2009 to lower the incidence rate of health
care–associated infections. HHS set 9 targets for hospitals to hit by 2013 for
infection reduction and adherence to prevention practices. So far, hospitals
are on track to achieve 6 of the 9 targets, according to the CDC.

One of those 6
goals is lowering the incidence of central line–associated bloodstream
infections by 50%. The agency reports a 33% reduction in 2010 from the baseline
period. Likewise, by 2010, hospitals achieved:

• A 7% reduction from baseline in catheter-associated
  urinary tract infections (the goal is 25%);


• A 10% reduction in surgical-site infections, also
  targeted for a 25% drop; and


• An 18.2% reduction in invasive methicillin-resistant Staphylococcus aureus
  infections, which HHS wants to lower by 50%.

Bravo for
Better Hand-Washing

Physicians,
nurses, and other healthcare professionals have enjoyed more success preventing
these infections by strictly observing best practices in infection control. The
5-year HHS action plan set goals for these routines, too, and the CDC says
clinicians are well on their way to reaching them. For example, central-line
insertion guidelines call on clinicians to properly wash their hands
beforehand, don sterile apparel, use a recommended antiseptic to prepare the
patient's skin, and make sure the antiseptic is dry before insertion. Through
the first 8 months of 2011, hospitals reported 95.7% adherence to these rules,
up from 92.2% in 2009. HHS is aiming for 100% adherence.

The CDC said
hospitals are also likely to achieve perfection when it comes to following
guidelines for preventing surgical-site infections.

One source of frustration
are C difficile infections. HHS wants
to reduce C difficile–triggered
hospitalizations by 30%. However, hitting that target on schedule is unlikely,
officials say, given how the incidence rate rose by 6.8% in 2010 compared with
a baseline of 8.8 hospitalizations with C difficile per
1000 discharges in 2008.

In a press
release, CDC Director Thomas R. Frieden, MD, MPH, said that hospitals and state
health departments need to translate the progress they have achieved with other
iatrogenic infections to C difficile.

More information
about the national war on health care–associated infections is available on the
CDC Web site.

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Authors and Disclosures

Journalist

Robert Lowes

Robert Lowes is a journalist for Medscape
Medical News. A former senior editor at Medical Economics magazine and
contributor to numerous healthcare publications, Robert has covered medicine
from almost every conceivable angle — public policy, managed care, education,
ethics, medical malpractice, information technology, billing and collections,
waiting-room design, and first-degree murder. His articles have won major
awards such as first place in the annual journalism competition of the National
Institute for Health Care Management, and several have been republished in
books. Robert also is an anthologized poet. He can be contacted at
rlowes@medscape.net.



Robert Lowes has disclosed no relevant financial relationships.