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Hospitals could reduce HAIs by up to 55%

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September 21, 2018

Peter Schreiber
Peter Schreiber
Photo of Keith Kaye
Keith S. Kaye

A large systematic review and meta-analysis showed that hospitals could reduce health care-associated infections, or HAIs, by 35% to 55% with systematic implementation of evidence-based infection prevention and control measures.

The findings were published in Infection Control & Hospital Epidemiology.

“The results of this study show that there is still a lot we can do to prevent health care-associated infections,” Peter W. Schreiber, MD, attending physician in the division of infectious diseases and hospital epidemiology at University Hospital Zurich, told Infectious Disease News. “Even in high-income countries, where high adherence to current recommendations may be expected, there remains considerable room for improvement.”

Schreiber and colleagues searched OVID Medline, EMBASE, CINAHL, PubMed and The Cochrane Library for studies published between Jan. 1, 2005, and Oct. 7, 2016, that measured interventions to reduce catheter-associated urinary tract infections (CAUTIs), central-line associated bloodstream infections (CLABSIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAP) and hospital acquired pneumonia not associated with mechanical ventilation in acute-care and long-term care settings. They determined pooled risk ratio estimates for studies reporting raw rates.

The researchers identified 5,226 articles and included 144 studies in the final analysis. Fifty-six of the studies were conducted in the United States. The pooled incidence rate ratios associated with multifaceted interventions were 0.543 (95% CI, 0.445-0.662) for CAUTIs, 0.459 (95% CI, 0.318-9.554) for CLABSI and 0.553 (95% CI, 0.465-0.657) for VAP. The pooled rate ratio for intervention aimed at SSIs was 0.461 (95% CI, 0.389-0.546). Pooled rate ratios for VAP reduction initiatives were 0.611 (95% CI, 0.414-0.900) for before-and-after studies, and 0.509 (95% CI, 0.277-0.937) for randomized controlled trials.

Schreiber and colleagues reported that the reduction of infection rates were independent of the economic status of study countries, and that most studies (99.3%) had a high risk for bias.

“Implementing multifaceted strategies in infection prevention and control is our best line of defense to bring infection rates down and keep patients safe,” Schreiber said. “We hope these findings will motivate health care institutions that aim to improve quality of patient care and to reduce infection rates to develop their own customized, multifaceted strategies to improve patient outcomes.”

The study results were released in conjunction with Outbreak Prevention and Response Week, which is hosted by The Society for Healthcare Epidemiology of America (SHEA) and its partners.

“Health care-associated infections come at a considerable expense to patients and families, but also cost the U.S. health care system an estimated $9.8 billion each year,” Infectious Disease News Editorial Board member Keith S. Kaye, MD, MPH, SHEA present and professor of internal medicine at the University of Michigan Medical School, said in a news release.

“There have been tremendous advancements in developing strategies to prevent and control HAIs. This study demonstrates a need to remain vigilant in identifying and maintaining key infection control processes to ensure they can be optimally used to prevent infections, which in some cases, are life-threatening.”   by Bruce Thiel

Disclosures: The authors report no relevant financial disclosures.