US Pharm. 2013;38(4):6.

The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), the newest branch of the CDC, works to prevent infections, protect people, and save lives. NCEZID focuses on several distinct areas: foodborne illness; antimicrobial resistance; deadly diseases; illnesses affecting immigrants; diseases spread by mosquitoes, ticks, and fleas; and health care (HC)–associated infections (HAIs). HAIs occur in patients being treated in an HC setting for another condition. The CDC estimates that 10% (4.1 million) of hospitalized patients develop HAIs. The use of central venous catheters (CVCs)—also called central lines—is common in both inpatient and outpatient care; almost 300 million CVCs are used annually. Three-quarters of all HAIs are due to four types of infection: urinary tract infections (34%), surgical-site infections (17%), bloodstream infections (14%), and pneumonia (13%).

Costs: The annual direct cost associated with HAIs is estimated to be between $28 billion and $33 billion. A 2010 report issued by the Office of Inspector General of the U.S. Department of Health and Human Services (HHS) estimated that adverse and temporary-harm events associated with hospital care (including HAIs) cost Medicare more than $300 million in just a single month in 2008. Most costs were associated with greater length of stay due to the harm caused.

Bloodstream Infections: CVCs are the most frequent cause of HC-associated bloodstream infection (HCABI), which differs from catheter-related bloodstream infection (CRBSI). CRBSI is ruled out as a contributor to HCABI through rigorous laboratory testing. Annually, 41,000 central line–associated bloodstream infections (CLABSIs) in hospitals occur in the course of use or are caused by microorganisms colonizing the external surface of the device or the fluid pathway when the device is inserted. These infections are usually serious, typically resulting in prolonged hospital stays, increased costs, and a greater mortality risk. The CDC estimates that, in 2008, 37,000 CLABSIs occurred among patients receiving outpatient hemodialysis. The CDC recently estimated the cost of each CLABSI to be $16,550. The CDC’s Healthcare Infection Control Practices Advisory Committee published guidelines for preventing intravascular catheter-related infections in 2011. More recently, the HHS developed the National Action Plan to Prevent Healthcare-Associated Infections, which sets national targets for monitoring and preventing HAIs.

Comments: The CDC and six other professional groups have called for the elimination of HAIs, most of which are preventable. A reduction of different types of HAI by 7% to 41% has been documented. To further reduce the incidence of HAI, HC professionals must adhere to evidence-based practices, introduce financial incentives, improve personal accountability, and work toward reinforcement of collaborative practices.

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