Bloodstream Infections Decreasing Sharply in ICUs, According to the Centers for Disease Control and Prevention

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CDC Vital Signs Report: Infections remain an issue hospital wide and in other health care settings such as dialysis centers

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Reduction in Bloodstream Infections

This reduction is the result of hospital, local, state and national medical and public health efforts focused on tracking infection rates and then using that information to tailor and evaluate prevention programs.

Compared to 2001, healthcare providers reduced bloodstream infections in hospital intensive care unit patients with central lines by 58% in 2009, according to a new CDC Vital Signs report. Cumulatively, that decrease represented up to 27,000 lives saved and $1.8 billion in excess health care costs. Even so, many bloodstream infections continue to occur throughout hospitals and in outpatient dialysis clinics.

A central line is a tube that is placed in a large vein of a patient’s body – usually the neck or chest -- to give important medical treatment in an intensive care unit, elsewhere in the hospital, and during dialysis. When not put in correctly or kept clean, central lines can become a path for germs to enter the body and cause bloodstream infections. Bloodstream infections in patients with central lines can be deadly, killing as many as 1 in 4 patients who gets one.

“Preventing bloodstream infections is not only possible, it should be expected. Meticulous insertion and care of the central line by all members of the clinical care team including doctors, nurses and others at the bedside is essential. The next step is to apply what we’ve learned from this to other healthcare settings and other healthcare-associated conditions so that all patients are protected,” said Thomas R. Frieden, M.D., M.P.H., CDC director.

The report also found that in 2009 alone, about 60,000 bloodstream infections in patients with central lines occurred in non-ICU health care settings such as hospital wards and kidney dialysis clinics. About 23,000 of these occurred in non-ICU patients (2009) and about 37,000 infections occurred in dialysis clinics patients (2008).

“This reduction is the result of hospital, local, state and national medical and public health efforts focused on tracking infection rates and then using that information to tailor and evaluate prevention programs,” said Denise Cardo, M.D., director of CDC’s Division of Healthcare Quality Promotion. “The report findings point to a clear need for action beyond ICUs. Fortunately, we have a prevention model focused on full collaboration that can be applied broadly to maximize prevention efforts.”

Infections are one of the leading causes of hospitalization and death for hemodialysis patients. At any given time, about 350,000 people are receiving hemodialysis treatment for kidney failure. Seven in 10 patients who receive dialysis begin that treatment through a central line.

Everyone Has a Role to Play in Prevention

CDC partners with other federal agencies, including the Agency for Healthcare Research and Quality and Centers for Medicare and Medicaid Services, as well as states, health care providers, and consumer groups. CDC is working toward prevention goals detailed in the U.S. Department of Health and Human Services’ Action Plan to Prevent Healthcare-Associated Infections.

“These partnerships have fueled our prevention success, saving lives and moving us one step closer to eliminating healthcare-associated infections,” said Cardo. “Now we must continue to implement what we know works and look at data to measure impact, all while continuing to research and fill remaining knowledge gaps.”

To prevent bloodstream infections in patients with central lines, hospitals, dialysis centers, and other medical care locations can:

  • Make sure CDC infection control guidelines are followed every time a central line is put in and used.
  • Encourage staff members to speak up when guidelines aren’t followed.
  • Use data for action. Track infection rates and germ types with CDC’s National Healthcare Safety Network (NHSN) to learn where and why infections are happening, target actions to stop them, and track progress.
  • Recognize staff members or units that work hard to prevent central line infections or that solve issues with infection control.
  • Join state-based prevention programs such as the AHRQ-funded expansion of On the CUSP: Stop BSIs.

Patients with central lines and their caregivers can prevent bloodstream infections by asking their doctors and nurses to clean their hands before and after touching patients. In addition, ask which infection prevention methods will be used, why a central line is needed, and how long it will be in. Tell a nurse or doctor if the area around the central line becomes sore or red, or if the bandage falls off or looks wet or dirty.

CDC works in partnership with health departments, health care facilities, providers, and consumers to promote implementation of best practices, relying on CDC guidelines for infection prevention and using the National Healthcare Safety Network to track infections and monitor progress.

Video of Dr. Denise Cardo as originally seen on Medscape.


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