Little Resistance to Rising Hospital-Acquired Infections

Antibiotic resistance to hospital-acquired infections (HAIs) is rising at faster rates than predicted in 2008 by the Centers for Disease Control and Prevention (CDC), according to an analysis of privately gathered data reported in a recent commentary in Antimicrobial Agents and Chemotherapy, concluding that resistance is “at crisis levels.”³

Antibiotic-resistant microbes infect more than 2 million Americans each year and kill more than 100,000.

“We must act to find new weapons in the global battle against deadly superbugs,” particularly three common HAIs: acinetobacter, E. coli, and klebsiella, said co-author Brad Spellberg, MD, infectious-disease specialist at Harbor-UCLA Medical Center in Los Angeles.

A recent fact sheet from the Alliance for Aging Research notes that older patients, who represent 45% of HAIs annually, carry a higher burden of illness and less favorable outcomes than younger patients.⁴

Meanwhile, a study of the ICUs at 43 Hospital Corporation of America hospitals, published in the New England Journal of Medicine, provides support for treating all ICU patients with universal precautions for methicillin-resistant Staphylococcus aureus (MRSA).⁵ Washing all ICU patients with antibiotic soap and administering nasal antibiotics reduced all types of bloodstream infections by 44% and proved more effective than the common practice of screening patients for MRSA first, then treating those testing positive.

Another recent resource for HAIs is the “Eliminating Catheter-Associated Urinary Tract Infections” guide from the American Hospital Association’s Hospitals in Pursuit of Excellence unit.⁶ The booklet recommends an evidence-based, three-step action plan derived from AHA’s On the CUSP: Stop CAUTI project, and is available free on the AHA website. It has an accompanying webinar, which outlines the business case for eliminating catheter-associated urinary tract infections (CAUTIs) and the importance of hospital culture in achieving sustainability.

Larry Beresford is a freelance writer in San Francisco.

References

1. Harrison J, Quinn K, Mourad M. Is anyone home? The association between being reached for a post-discharge telephone call and 30-day hospital readmission. Harrison J, Quinn K, Mourad M. Any questions? The relationship between responses to post-discharge call questions and 30-day hospital readmissions [abstracts]. Journal of Hospital Medicine, 2013, 8 Suppl 1.
2. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Institute of Medicine website. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf. Accessed Sept. 9, 2013.
3. Shlaes DM, Sahm D, Opiela C, Spellberg B. Commentary: the FDA reboot of antibiotic development. Antimicrob Agents Chemother. 29 Jul 2013 [Epub ahead of print].
4. Alliance for Aging Research. HAIs growing problem, group says. Alliance for Aging Research website. Available at: http://www.agingresearch.org/content/article/detail/33504. Accessed Sept. 9, 2013.
5. Huang SS, Septimus E, Kleinman K, et al. Targeted versus universal decolonization to prevent ICU infection. N Engl J Med. 2013;368:2255-2265.
6. Hospitals in Pursuit of Excellence. Eliminating catheter-associated urinary tract infections. Hospitals in Pursuit of Excellence website. Available at: http://www.hpoe.org/Reports-HPOE/eliminating_catheter_associated_urinary_tract_infection.pdf. Accessed Sept. 9, 2013.
7. Center to Advance Palliative Care. Growth of palliative care in U.S. hospitals 2013 snapshot. Center to Advance Palliative Care website. Available at: http://www.capc.org/capc-growth-analysis-snapshot-2013.pdf. Accessed Sept. 9, 2013.