Hospital Infection Rates Are On The Downslide (With One Troubling Exception)

California hospitals are getting better at preventing infections in their patients, according to new data from the California Department of Public Health.

Hospitals and other health care facilities have been known as hotbeds of infection for years. The industry, with government prompting, has zeroed in on a cleanup.  Between 2008 and 2014, the department reported, surgical site infections in California have declined by 40 percent and catheter-tube associated bloodstream infections by 49 percent.

The reported data lag by a full year, but the trend in California is clear. Most types of hospital infections, including the “superbug” MRSA bacterium, declined 24 percent since 2011. Similar results are being reported around the nation.

“Not every hospital has seen reductions, but overall, we definitely see improvement,” said Lynn Janssen, chief of the public health agency’s health care-acquired infections program.

However, one bug is on the rise in California: the worm-shaped Clostridium difficile, which infects the intestine, causes diarrhea and fever, and can be life-threatening. Since 2011, its hospital infection rate is up 11 percent.

Known as C. diff in hospital jargon, the bacterium is proliferating in large part through the overuse of antibiotics, health officials say.

Overuse in effect breeds C. diff strains that are highly resistant to the drugs. The more robust organisms require extra diligence in seemingly simple, but hard-in-reality, practices  such as meticulous hand-washing and room cleaning.

Despite the progress in general, health officials warn that hospitals have a long way to go in cleaning up: more than 19,000 potentially life-threatening infections of many varieties were reported in 2014.

Nationwide, an estimated $9.8 billion is spent each year on treating health care-acquired infections, and hospitals are under financial pressure from insurers and federal agencies to prevent them.

Health care facilities have spent millions improving their cleaning and sterilization measures, patient care procedures and worker training to keep infections from occurring and spreading.

A catheter-tube bloodstream infection can add an average of nearly $46,000 to a patient’s medical bill, while a C. difficile infection can boost a medical bill by about $11,000. Medicare now reduces payments to hospitals with infection rates it considers too high.

Another prod to hospitals: public reporting of infections, including individual hospital performance.

California is among 32 states that require hospitals and other facilities like nursing homes to report certain kinds of “health care-associated infections” to state and national health agencies.

“We think that having that kind of transparency really makes administrators take notice,” Janssen said. “We target hospitals that have high infection rates and we offer to come in and provide an on-site assessment of practices. It has made an impact.”

Dr. David Perrott, senior vice president and chief medical officer of the California Hospital Association, said his group was “encouraged by the overall improvement. … We have more hospitals engaged (in infection prevention), but we are disappointed in the C. difficile rates.”

Perrott said restricting antibiotic use both in and out of hospitals could help reduce those infections. In addition, some hospitals lag behind their peers on improving their infection control measures, he noted.

It takes time for those improvements to make a difference in infection rates, Perrott said. “It just doesn’t happen overnight.”

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