Becker's Clinical Quality & Infection Control

56 INFECTION PREVENTION & ANTIBIOTIC RESISTANCE 5 Highlights From the CDC's Annual HAI Progress Report By Shannon Barnet R esults of the CDC's National and State Healthcare-Associated Infections Progress Report show hospitals are getting better at fighting HAIs, particularly drug-resistant superbugs. e 2016 report includes national and state- by-state summaries of six HAI types, based on data reported to the CDC's National Healthcare Safety Network in 2014. Progress on HAI prevention is measured using the standardized infection ratio. Here are five highlights from the report. 1. Central line-associated bloodstream infections among national acute care hos- pitals decreased 50 percent between 2008 and 2014. 2. Although there was no significant change in the national catheter-associat- ed urinary tract infection rate between 2009 and 2014, progress was identified in non-intensive care unit settings during that time, as well as progress in all settings between 2013 and 2014. 3. Based on 10 types of procedures, surgical site infections decreased 17 percent from previous reports. Specifically between 2008 and 2014, abdominal hysterectomy SSIs dipped 17 percent and colon surgery SSIs fell 2 percent. 4. Between 2011 and 2014, hospital-on- set Clostridium difficile infections were reduced 8 percent. 5. Hospital-onset methicillin-resistant Staph- ylococcus aureus bacteremia fell 13 percent between 2011 and 2014. n C. diff Transmission in Hospitalized Patients, Asymptomatic Carriers and Community Sources By Shannon Barnet E ven though Clostridium difficile infections affect more than 250,000 hospital patients each year, relatively little is known about how the bacterium spreads. To learn more, researchers examined the effect of hospital and community-based C. diff transmission and control measures in a study published in March in the CDC journal Emerging Infectious Diseases. The study was led by Yale School of Public Health in New Haven, Conn., and Washington University School of Medicine in St. Louis. The research team constructed a C. diff transmission model within and between hospi- tal, community and long-term care-facility settings. Using the model, the team found hospitalized patients with symptoms of C. diff transmitted the infection at a rate 15 times higher than asymptomatic patients, even af- ter accounting for infection control measures. Additional- ly, the rates of transmission among residents in long-term care facilities and in the community were 27 percent and 0.1 percent that of hospitalized patients, respectively. "Despite lower transmission rates for asymptomatic carriers and community sources, these transmission routes have a substantial effect on hospital-onset CDI because of the larger reservoir of hospitalized carriers and persons in the community," the study concluded. "Asymptomatic carriers and community sources should be accounted for when designing and evaluating con- trol interventions." n Research Reveals C. diff is More Common in Community Than Previously Realized By Shannon Barnet F requently, when people hear about Clostridium difficile, they think of hospitals or other healthcare settings. New research, however, suggests the bacte- rium may be more common in the general community than previously realized, according to a Popular Science report. A group of Chinese researchers collected fecal samples from 3,699 healthy Chinese individuals over the course of one year, from September 2013 to September 2014. To ensure the statistics included solely those with no medical issues, the researchers excluded anyone exhibiting symp- toms of diarrhea or gastrointestinal infection or individuals who might have been on antibiotics. Ultimately, they discovered the bacterium was quite prevalent in the community, especially in children. The highest C. diff rate was observed in infants with roughly one-quarter of those under one year old carrying the bacterium. Among children, the average rate was 13.6 percent, and among healthy adults, the average rate was 5.5 percent. In addition to being prevalent, the toxicity levels of the C. diff isolates were concerning — nearly 20 percent of the samples had toxin-forming genes. In children and adults, that number is closer to 65 percent. The results of the study suggest healthy individuals may be able to carry C. diff without an actual infection, posing an increased risk to anyone who might be susceptible, accord- ing to the report. n

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