From the August 2011 issue of HealthCare Business News magazine
Another way scientists look at MDROs is by infection site – or how the bug is transmitted. Hospitals employ a wide variety of invasive devices and procedures to treat patients. Some of these techniques can leave behind unwanted guests.
The four most common sites of hospital-associated infections are: central line-associated bloodstream infection (CLABSI), surgical site infection (SSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP); VAP accounts for a large proportion of HAIs.
Where do these bacteria hide? Right out in the open – and all over the health care facility, suggests research. A study conducted by researchers from Indiana University, TriHealth Laboratory and Xavier University found that 85 percent of mattresses and bed decks contain a variety of bacteria, even after being disinfected by housekeeping staff.
On the mend
The good news is that rates of MRSA are coming down. In the decade between 1992 and 2003, notes Cleeman, hospital-onset MRSA dropped by 28 percent. “The decrease is probably because of our ability to detect the bug, isolate the patient and decolonize the bacteria (in other words, remove MRSA) – as well as our efforts at prevention.”
Dr. John Jernigan, director of the CDC’s Office of HAI Prevention Research and Evaluation, agrees. “More of the advances in prevention can be attributed to better implementation of existing recommendations than to new developments,” he explains. These recommendations include hand hygiene, approaches for inserting certain medical devices, pre-operative practices and contact precautions.
The CDC is conducting research on HAI prevention by investigating and analyzing outbreaks and by collaborating with academic researchers through five epicenters around the country. These epicenters are looking into ways to disinfect hospital rooms, tests to identify patients who truly need antibiotics, use of probiotics (benign germs that can crowd out the more harmful ones), use of topical microbials to decrease patient risk and regional approaches to preventing the spread of MDROs. To date, health care providers look at the individual facility; patients, though, can carry HAIs, for instance, from a hospital to a nursing home or from one hospital to another, notes Jernigan.
Implementation on the CUSP
According to the Joint Commission, there’s no single way to combat HAIs. Rather, the health care certification organization recommends “bundling” or implementing several changes at the same time. For instance, to prevent surgical site infections, the Joint Commission proposes maintaining glucose control and avoiding shaving the surgical site.
