Healthcare-Associated Infections—Community Interface (HAIC)

handwash prepOverview

The healthcare-associated infection (HAI) component of CEIP engages a network of local health jurisdictions, local hospitals, and academic medical center partners to help answer critical questions about emerging HAI threats, advanced infection tracking methods, and antibiotic resistance in the United States. When combined with HAI data gathered by other EIPs, this information will play a key role in shaping future policies and recommendations targeting HAI prevention.

Current Projects

1. Clostridium difficile infection (CDI) surveillance in San Francisco County

2. Healthcare-associated Infections and Antibiotic Use Prevalence Survey

A point prevalence survey conducted on a single day at participating healthcare facilities. The primary objectives of the HAI/antimicrobial use prevalence survey effort are to:

  • estimate HAI prevalence in a large sample of inpatients in US acute healthcare facilities
  • determine the distribution of HAI by pathogen (including antimicrobial-resistant pathogens) and major infection site
  • estimate the prevalence and describe the rationale for antimicrobial use in a large sample of inpatients in US acute healthcare facilities.

Phase 1—Conducted at hospitals in one US city (non-EIP site).

Phase 2—The survey was conducted in all 10 EIP states. 2,015 patients admitted to acute care healthcare facilities were surveyed at 22 acute care facilities. Published results.

Phase 3—The survey was conducted in the 10 EIP states. 11,282 patients admitted to acute care healthcare facilities were surveyed at 183 acute care facilities. Published results—Point Prevalence Survey of Antimicrobial Use in U.S. Acute Care Hospitals. Shelley Magill, Laura McAllister, Melinda Neuhauser, et al. Oral Presentation Session 37, abstract 114 presented at: ID Week 2012. 1st Annual Joint Meeting of ISDA, SHEA, HIVMA, and PIDS; 2012 Oct 16-21; San Diego, CA.

Phase 4—The survey will be conducted at all sites in the EIP network. Each EIP site will enroll 25 acute healthcare facilities and conduct surveys in Spring/Summer 2015.

Completed Projects

1. NHSN Denominator Simplification Project – [Published March 2013]

An HAI denominator data collection validation and simplification project in selected acute healthcare facilities (hospitals) was conducted at 10 EIP sites. The results of this project will be used to assess the feasibility and accuracy of using a simplified method for ascertaining HAI denominator data for the National Healthcare Safety Network (NHSN) and will be used to determine how to modify current methodology for NHSN denominator data collection. The primary purpose of the project was to evaluate a simplified, less resource-intense method for obtaining device-days data (compared to current manual data collection practices) to determine if sampling methods can successfully be implemented to collect denominator data and can generate estimates of device-days that are acceptable for HAI surveillance purposes. The primary objectives were to:

  • retrospectively assess the feasibility of using sampling methods to obtain estimates of central line-days by analyzing existing data on patient-days and device-days data collected from a large number and variety of inpatient units (both ICU and non-ICU) within acute healthcare facilities
  • prospectively assess the feasibility of implementing the use of sampling methods to collect patient-days and central line-days denominator data
  • validate estimates of central line-days derived from denominator data collected using sampling methodology against data collected using current denominator data collection practices, and to determine if estimates of central line-days and central line-associated bloodstream infection (CLABSI) rates generated are suitable for the purposes of conducting HAI surveillance and reporting data to NHSN

2. Antibiotic Appropriate Use (Pilot)

Pilot assessment to characterize the indications and documentation related to prescribing select antimicrobial agents to patients in short-stay acute care hospitals identified during the 2011 Phase 3 HAI/antimicrobial use prevalence survey. The primary objectives of this pilot are to:

  • test the methods of assessing appropriate prescribing for a full scale evaluation at all eligible facilities in 2013
  • determine the proportion of inappropriate antimicrobial use
  • inform an independent effort by CDC to create freely available antimicrobial use assessment audit tools for healthcare personnel to utilize in practice improvement initiatives at their hospitals

Links

Publications

Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014;370:1198-208.

CDC Vital Signs Making Health Care Safer, Antibiotic Rx in Hospitals: Proceed with Caution, March 2014

Thompson ND, Edwards JR, Bamberg W, Beldavs Z, Dumyati G, Godine D, Maloney M, Kainer M, Ray S; Thompson D, Wilson L, Magill SS. Evaluating the accuracy of sampling to estimate central line–days: simplification of the National Healthcare Safety Network surveillance methods. Infect Control Hosp Epidemiol 2013;  34(3):221-228.

Magill S, McAllister L, Neuhauser M, et al. HAI and antimicrobial use prevalence survey phase 3: point prevalence survey of antimicrobial use in US acute care hospitals. Oral Presentation Session 37, abstract 114 presented at: ID Week 2012. 1st Annual Joint Meeting of ISDA, SHEA, HIVMA, and PIDS; 2012 Oct 16-21; San Diego, CA.

Magill S, McAllister L, Allen-Bridson K, et al. HAI and antimicrobial use prevalence survey phase 2: preliminary results of a healthcare-associated infection and antimicrobial use prevalence survey in 22 US acute care hospitals. Abstract. SHEA 2011 April 1-4; Dallas, TX.

Contact

For questions about HAI surveillance and HAI projects please contact Joelle Nadle, MPH.

Joelle Nadle, MPH
Project Coordinator, HAIC and MRSA
haic@ceip.us