Changes in Prevalence of Health Care–Associated Infections in U.S. Hospitals

Ss, Magill; O’Leary, Erin; Sj, Janelle; Dl, Thompson; Dumyati, Ghinwa; Nadle, Joelle; Le, Wilson; Kainer, Marion A.; Lynfield, Ruth; Greissman, Samantha; Ray, Susan M.; Beldavs, Zintars G.; Gross, Cindy; Bamberg, Wendy; Sievers, Marla; Concannon, Cathleen; Buhr, Nicolai; Warnke, Linn; Maloney, Meghan; Ocampo, Valerie; Brooks, Jo Ann; Oyewumi, Tolulope; Sharmin, Shamima; Richards, Katherine; Rainbow, Jean; Samper, Monika; Eb, Hancock; Leaptrot, Denise; Scalise, Eileen; Badrun, Farzana; Phelps, Randy; Edwards,

doi:10.1056/nejmoa1801550

Cited by 840 publications

(710 citation statements)

References 19 publications

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“…Healthcare-associated infections are the most common adverse events in hospitals, responsible for substantial morbidity, mortality and costs (1,2). According to a point-prevalence survey conducted in 199 hospitals in 2015, pneumonia was the most frequent healthcare-associated infection in the United States, and its prevalence has remained relatively stable in the last few years, compared with the substantial reductions in other nosocomial infections such as surgical site and urinary tract infections (3). Among healthcare-associated infections, pneumonia is the leading cause of death (4).…”

Section: Introductionmentioning

confidence: 99%

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

et al. 2019

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Introduction: Healthcare-associated infections are an important cause of morbidity and mortality, are among the most common adverse events in healthcare, and of them, pneumonia is the most commonly reported. Our objective was to evaluate the incidence and clinical outcome of respiratory viruses in hospital-acquired pneumonia (HAP). Methods: This was a prospective cohort study, include patients aged between 0 and 18 who fulfilled Centers for Diseases Control and Prevention (CDC) criteria for HAP. Demographic and clinical data were obtained, and a nasopharyngeal swab specimen was taken for the detection of respiratory viruses. All included patients were monitored until discharge to collect data on the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality. All-cause 30-day mortality was also ascertained. Results: Four thousand three hundred twenty-seven patients were followed for 42,658 patient-days and 5,150 ventilator-days. Eighty-eight patients (2.03%) met the CDC criteria for HAP, 63 patients were included, and clinical and epidemiological characteristics showed no statistically significant differences between patients with virus associated healthcare-associated pneumonia (VAHAP) and those with non-viral healthcare-associated pneumonia (NVHAP). At least one respiratory virus was detected in 65% [95% CI (53–77)] of episodes of HAP, with a single viral pathogen observed in 53.9% and coinfection with 2 viruses in 11.1% of cases. The outcome in terms of ICU admission, mechanical ventilation and the 30-day mortality did not show a significant difference between groups. Conclusions: In two-thirds of the patients a respiratory virus was identified. There was no difference in mortality or the rest of the clinical outcome variables. About half of the patients required mechanical ventilation and 10% died, which emphasizes the importance of considering these pathogens in nosocomial infections, since their identification can influence the decrease in hospital costs and be taken into account in infection control policies.

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Section: Introductionmentioning

confidence: 99%

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

et al. 2019

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“…The reductions in point prevalence of HAIs as well as urinary and central line catheter use demonstrated by Magill and colleagues18 are encouraging to both clinicians and policymakers. It remains unclear how much of the decreases in HAIs are due to value-based purchasing programmes or to advances in development and implementation of technical and socioadaptive interventions in recent years, especially given declining rates in several of these HAIs since national surveillance began.…”

Section: Discussionmentioning

confidence: 82%

“…Given this significant national attention to HAIs, Magill and colleagues18 examined how HAI rates have changed in recent years by performing a multistate point prevalence medical record review study of acute care hospitalisations to compare rates of HAIs in 2015 to rates measured in 2011 using the same protocol and HAI definitions. This study included 199 acute care hospitals in 10 states and involved a 1-day medical record review for a random selection of 12 299 patients.…”

Section: Changes In Prevalence Of Health Care-associated Infections Imentioning

confidence: 99%

Quality & safety in the literature: July 2019

2019

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“…Cross‐infection in endoscopy should be viewed in the context of patients admitted to hospital for other reasons. Centers for Disease Control and Prevention audited 633,300 US hospital inpatients in 2015 and reported the prevalence of health‐care‐associated infection to be 3.2% . ASGE Standards of Practice Committee in 2012 estimated the risk of post‐ERCP cholangitis to be <1% .…”

Section: Cross‐infection the Achilles Heel Of Endoscopymentioning

confidence: 99%

“…Centers for Disease Control and Prevention audited 633,300 US hospital inpatients in 2015 and reported the prevalence of health-care-associated infection to be 3.2%. 42 ASGE Standards of Practice Committee in 2012 estimated the risk of post-ERCP cholangitis to be <1%. 43 A large single-center audit of 11,497 ERCP reported the risk of post-ERCP infection to be 0.3%.…”

Section: Risk Of Endoscope-generated Sepsis In Contextmentioning

confidence: 99%

Fifty years of digestive endoscopy: Successes, setbacks, solutions and the future

Axon

2020

Digestive Endoscopy

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Flexible endoscopes became generally available 50 years ago and created a revolution in the practice of gastroenterology. They improved diagnosis enormously, enabled quicker, less invasive, and more cost‐effective surgical treatment, while endoscopic screening has prevented many cancer deaths. The new technology stimulated research leading to a better understanding of gastrointestinal pathology, identifying new diseases and clarifying the etiology of others. Better‐controlled clinical trials accelerated the use of newer and more effective drugs. National and international endoscopy societies supported nursing input, encouraged research, stimulated specialist journals, and devised guidelines that encouraged audit and quality assurance. Advances in instrument design and the manufacture of new accessories enhanced endoscopic technique, diagnostic ability, patient comfort, and safety. The risk of cross‐infection inherent in the use of complex labile equipment that cannot be autoclaved remains a challenge. Endoscopy societies working closely with industry have established rigid protocols for high‐level disinfection that minimize the risks, but strict adherence to guidelines and continued vigilance is essential, especially with the increasing prevalence of antibiotic‐resistant commensals that can give rise to opportunistic infection. Government health departments have a responsibility to encourage and support research in this area by endoscopists, instrument manufacturers, and the pharmaceutical industry. Current trends suggest that in the future, artificial intelligence will greatly improve endoscopic diagnosis, and that therapeutic endoscopy will expand, encouraging endoscopists to subspecialize.

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Changes in Prevalence of Health Care–Associated Infections in U.S. Hospitals

Cited by 840 publications

References 19 publications

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

Quality & safety in the literature: July 2019

Fifty years of digestive endoscopy: Successes, setbacks, solutions and the future

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