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Prevalence of Healthcare-Associated Infections in Acute Care Hospitals in Jacksonville, Florida

Published online by Cambridge University Press:  02 January 2015

Shelley S. Magill*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Walter Hellinger
Affiliation:
Mayo Clinic, Jacksonville, Florida
Jessica Cohen
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Atlanta Research and Education Foundation, Decatur, Georgia
Robyn Kay
Affiliation:
Florida Department of Health, Jacksonville, Florida
Christine Bailey
Affiliation:
Wolfson Children's Hospital, Jacksonville, Florida
Bonnie Boland
Affiliation:
Baptist Medical Center Downtown, Jacksonville, Florida
Darlene Carey
Affiliation:
University of Florida/Shands Hospital, Jacksonville, Florida
Jessica de Guzman
Affiliation:
Baptist Medical Center Beaches, Jacksonville, Florida
Karen Dominguez
Affiliation:
St. Vincent's Medical Center, Jacksonville, Florida
Jonathan Edwards
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Lori Goraczewski
Affiliation:
Mayo Clinic, Jacksonville, Florida
Teresa Horan
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Melodee Miller
Affiliation:
Orange Park Medical Center, Orange Park, Florida
Marti Phelps
Affiliation:
St. Vincent's Medical Center, Jacksonville, Florida
Rebecca Saltford
Affiliation:
Baptist Medical Center South, Jacksonville, Florida
Jacquelyn Seibert
Affiliation:
Mayo Clinic, Jacksonville, Florida
Brenda Smith
Affiliation:
Mayo Clinic, Jacksonville, Florida
Patricia Starling
Affiliation:
Baptist Medical Center Beaches, Jacksonville, Florida
Bonnie Viergutz
Affiliation:
St. Luke's Hospital, Jacksonville, Florida
Karla Walsh
Affiliation:
Baptist Medical Center Downtown, Jacksonville, Florida
Mobeen Rathore
Affiliation:
Wolfson Children's Hospital, Jacksonville, Florida University of Florida, Jacksonville, Florida
Nilmarie Guzman
Affiliation:
University of Florida, Jacksonville, Florida
Scott Fridkin
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, MS A-24, Atlanta, GA 30333 (smagill@cdc.gov)

Abstract

Objective.

To determine healthcare-associated infection (HAI) prevalence in 9 hospitals in Jacksonville, Florida; to evaluate the performance of proxy indicators for HAIs; and to refine methodology in preparation for a multistate survey.

Design.

Point prevalence survey.

Patients.

Acute care inpatients of any age.

Methods.

HAIs were defined using National Healthcare Safety Network criteria. In each facility a trained primary team (PT) of infection prevention (IP) staff performed the survey on 1 day, reviewing records and collecting data on a random sample of inpatients. PTs assessed patients with one or more proxy indicators (abnormal white blood cell count, abnormal temperature, or antimicrobial therapy) for the presence of HAIs. An external IP expert team collected data from a subset of patient records reviewed by PTs to assess proxy indicator performance and PT data collection.

Results.

Of 851 patients surveyed by PTs, 51 had one or more HAIs (6.0%; 95% confidence interval, 4.5%–7.7%). Surgical site infections (n = 18), urinary tract infections (n = 9), pneumonia (n = 9), and bloodstream infections (n = 8) accounted for 75.8% of 58 HAIs detected by PTs. Staphylococcus aureus was the most common pathogen, causing 9 HAIs (15.5%). Antimicrobial therapy was the most sensitive proxy indicator, identifying 95.5% of patients with HAIs.

Conclusions.

HAI prevalence in this pilot was similar to that reported in the 1970s by the Centers for Disease Control and Prevention's Study on the Efficacy of Nosocomial Infection Control. Antimicrobial therapy was a sensitive screening variable with which to identify those patients at higher risk for infection and reduce data collection burden. Additional work is needed on validation and feasibility to extend this methodology to a national scale.

Infect Control Hosp Epidemiol 2012;33(3):283-291

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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Footnotes

a.

Present affiliations: Mayo Clinic, Jacksonville, Florida (D.C.); Tanner Medical Center, Villa Rica, Georgia (L.G.).

References

1. Wise, ME, Scott, RD, Ellingson, KD, et al. Burden of major hospital-onset device-associated infection types among adults and children in the United States, 2007. In: Program and Abstracts of the Annual Meeting of the Society for Healthcare Epidemiology of America. Dallas: Society for Healthcare Epidemiology of America, 2011. Abstract 303.Google Scholar
2. Kislak, JW, Eickhoff, TC, Finland, M. Hospital-acquired infections and antibiotic usage in the Boston City Hospital—January, 1964. New Engl J Med 1964;271:834835.Google Scholar
3. Barrett, FF, Casey, JI, Finland, M. Infections and antibiotic use among patients at Boston City Hospital February 1967. New Engl J Med 1968;278:59.Google Scholar
4. Eickhoff, TC, Brachman, PS, Bennett, JV, et al. Surveillance of nosocomial infections in community hospitals. I. Surveillance methods, effectiveness, and initial results. J Infect Dis 1969;120:305317.CrossRefGoogle ScholarPubMed
5. Hughes, JM. Nosocomial infection surveillance in the United States: historical perspective. Infect Control 1987;8:450453.Google Scholar
6. Haley, RW, Culver, DH, White, JW, et al. Study on the efficacy of nosocomial infection control (SENIC project): summary of study design. Am J Epidemiol 1980;111:472485.Google Scholar
7. Haley, RW, Hooton, TM, Culver, DH, et al. Nosocomial infections in U.S. hospitals, 1975–1976: estimated frequency by selected characteristics of patients. Am J Med 1981;70:947959.CrossRefGoogle ScholarPubMed
8. Klevens, RM, Edwards, JR, Richards, CL, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160166.Google Scholar
9. Llata, E, Gaynes, RP, Fridkin, S. Measuring the scope and magnitude of hospital-associated infection in the United States: the value of prevalence surveys. Clin Infect Dis 2009;48:14341440.CrossRefGoogle ScholarPubMed
10. Smyth, ET, Mcllvenny, G, Enstone, JE, et al. Four country healthcare-associated prevalence survey 2006: overview of results. J Hosp Infect 2008;69:230248.CrossRefGoogle Scholar
11. Lyytikäinen, O, Kanerva, M, Agthe, N, Möttönen, T, Ruutu, P; Finnish Prevalence Survey Study Group. Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005. J Hosp Infect 2008;69:288294.CrossRefGoogle Scholar
12. Gastmeier, P, Kampf, G, Wischnewsky, N, et al. Prevalence of nosocomial infections in representative German hospitals. J Hosp Infect 1998;38:3749.CrossRefGoogle ScholarPubMed
13. Struwe, J, Dumpis, U, Gulbinovic, J, Lagergren, A, Bergman, U. Healthcare-associated infections in university hospitals in Latvia, Lithuania and Sweden: a simple protocol for quality assessment. Euro Surveill 2006;11:167171.CrossRefGoogle ScholarPubMed
14. Scheel, O, Stormark, M. National prevalence survey on hospital infections in Norway. J Hosp Infect 1999;41:331335.Google Scholar
15. Vaque, J, Rossello, J, Arribas, JL, et al. Prevalence of nosocomial infections in Spain. J Hosp Infect 1999;43:105111.Google Scholar
16. French Prevalence Survey Study Group. Prevalence of nosocomial infections in France: results of the nationwide survey in 1996. J Hosp Infect 2000;46:186193.Google Scholar
17. Azzam, R, Dramaix, M. A one day prevalence survey of hospital-acquired infections in Lebanon. J Hosp Infect 2001;49:7478.Google Scholar
18. Zotti, CM, Messori, G, Charrier, L, et al. Hospital-acquired infections in Italy: a region wide prevalence study. J Hosp Infect 2003;56:142149.Google Scholar
19. Gikas, A, Pediaditis, J, Papadakis, JA, et al. Prevalence study of hospital-acquired infections in 14 Greek hospitals. J Hosp Infect 2002;50:269275.CrossRefGoogle ScholarPubMed
20. Plowman, R, Graves, N, Griffin, MA, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialities of a district general hospital in England and the national burden imposed. J Hosp Infect 2001;47:198209.CrossRefGoogle ScholarPubMed
21. Emmerson, AM, Enstone, JE, Griffin, MA, et al. The Second National Prevalence Survey of infection in hospitals: overview of the results. J Hosp Infect 1996;32:175190.CrossRefGoogle ScholarPubMed
22. Pittet, D, Harbarth, S, Ruef, C, et al. Prevalence and risk factors for nosocomial infection in four university hospitals in Switzerland. Infect Control Hosp Epidemiol 1997;20:3742.Google Scholar
23. Faria, S, Sodano, L, Gjata, A, et al. The first prevalence survey of nosocomial infections in the University Hospital Centre Mother Teresa of Tirana, Albania. J Hosp Infect 2007;65:244250.CrossRefGoogle Scholar
24. Hajdu, A, Samodova, OV, Carlsson, TR, et al. A point prevalence survey of hospital-acquired infections and antimicrobial use in a pediatric hospital in north-western Russia. J Hosp Infect 2007;66:378384.Google Scholar
25. Lee, MK, Chiu, CS, Chow, VC, et al. Prevalence of hospital infection and antibiotic use at a university medical Center in Hong Kong. J Hosp Infect 2007;65:341374.Google Scholar
26. Duerink, DO, Roeshadi, D, Wahjono, H, et al. Surveillance of healthcare-associated infections in Indonesian hospitals. J Hosp Infect 2006;62:219229.Google Scholar
27. Klavs, I, Luznik, TB, Skerl, M, et al. Prevalence of and risk factors for hospital-acquired infections in Slovenia: results of the first national survey, 2001. J Hosp Infect 2003;54:149157.Google Scholar
28. Kallel, H, Bahoul, M, Ksibi, H, et al. Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect 2005;59:343347.Google Scholar
29. Metintas, S, Akgun, Y, Durmaz, G, et al. Prevalence and characteristics of nosocomial infections in a Turkish university hospital. Am J Infect Control 2004;32:409413.CrossRefGoogle Scholar
30. Danchaivijitr, S, Judaeng, T, Sripalakij, S, Naksawas, K, Plipat, T. Prevalence of nosocomial infection in Thailand 2006. J Med Assoc Thai 2007;90:15241529.Google ScholarPubMed
31. Gravel, D, Matlow, A, Ofner-Agostini, M, et al. A point prevalence survey of healthcare-associated infections in pediatric populations in major Canadian acute care hospitals. Am J Infect Control 2007;35:157162.CrossRefGoogle ScholarPubMed
32. Gravel, D, Taylor, G, Ofner, M, et al. Point prevalence survey for healthcare-associated infections within Canadian adult acute-care hospitals. J Hosp Infect 2007;66:243248.Google Scholar
33. Gastmeier, P, Brauer, H, Hauer, T, et al. How many nosocomial infections are missed if identification is restricted to patients with either microbiology reports or antibiotic administration? Infect Control Hosp Epidemiol 1999;20:124127.CrossRefGoogle ScholarPubMed
34. Brusaferro, S, Regattin, L, Faruzzo, A, et al. Surveillance of hospital-acquired infections: a model for settings with resource constraints. Am J Infect Control 2006;34:362366.CrossRefGoogle Scholar
35. Centers for Disease Control and Prevention. National Healthcare Safety Network patient safety component manual. http://www.cdc.gov/nhsn/TOC_PSCManual.html. Accessed June 7, 2011.Google Scholar
36. Cardo, D, Dennehy, PH, Halverson, P, et al. Moving toward elimination of healthcare-associated infections: a call to action. Infect Control Hosp Epidemiol 2010;38:671675.Google Scholar
37. Dubberke, ER, Butler, AM, Yokoe, DS, et al. Multicenter study of Clostridium difficile infection rates from 2000 to 2006. Infect Control Hosp Epidemiol 2010;31:10301037.CrossRefGoogle ScholarPubMed
38. Zilberberg, MD, Tillotson, GS, McDonald, LC. Clostridium difficile infections among hospitalized children, 1997–2006. Emerg Infect Dis 2010;16:604609.Google Scholar
39. Klompas, M. Interobserver variability in ventilator-associated pneumonia surveillance. Am J Infect Control 2010;38:237239.Google Scholar
40. Malpiedi, P, Hota, B, Magill, S, et al. Interobserver variability in bloodstream infection determinations using National Healthcare Safety Network definitions. In: Program and Abstracts of Annual Meeting of the Society for Healthcare Epidemiology of America. Dallas: Society for Healthcare Epidemiology of America, 2011. Abstract 305.Google Scholar