HAIs increase morbidity, hospitalization, and cost. Increased scrutiny has been placed on HAIs associated with use of invasive medical devices. We describe the incidence, cost, and outcomes for device and non-device related HAIs.
HAIs were detected using an electronic surveillance tool & verified using standard NHSN definitions by 3 experienced infection preventionists for all inpatient encounters, >=18 years old, between July 1, 2008 and September 30, 2010. Cases were verified by review of electronic medical records and entered into a database at two urban hospitals comprising 640 beds. Clinical, cost, and demographic data were abstracted from the enterprisewide data warehouse.
There were 79,839 admissions from 62,647 patients representing 319,149 patient days. We identified 2707 HAIs among 2240 admissions in 2080 patients. HAIs developed in 3.3% of all patients with a rate of 8.5 HAIs/1000 patient days. A total of 1876 (90.2%) & 364 (9.8%) admissions resulted in a single or multiple HAIs, respectively. Eighty percent of all HAIs in patients who experienced a single infection were attributed to five infections: catheter associated UTIs (29.6%), surgical site infections (26%), Clostridium difficile infection (10.6%), non-ventilator healthcare associated pneumonia (8%), non-catheter associated UTIs (7.7%). The length of stay and total costs associated with these infections were (median length of stay [25th & 75 percentile], median daily total cost [25th, 75th percentile]): catheter-associated UTIs 11 days [7,18], $2,775 [$2,050, $3,835]; surgical site infections 16 days [4,11], $1,849 [$1,904, $3,224]; Clostridium difficile infection 13 days [7,19], $2,972 [$2,163, $4,011]; non-ventilator healthcare associated pneumonia 13 days [8,20], $3,606 [$2,673, $4,577]; non-catheter associated UTIs 16 days [8,25], $1,849 [$1,618, $2,436]. The median duration of hospitalization for encounters with HAI was 12 days [6,21], with a median total cost of $33,626/ patient [$15,060, $68,716].
Catheter associated UTIs and surgical site infections remain as the most common cause of HAIs. Clostridium difficile has become the most common microbial cause of HAIs. Nearly half of all HAIs were non-device related.
D. J. Pombo,
M. Keane, None
C. Taylor, None
R. Kleckner, None
S. Sumner, None
R. R. Mehta, None
J. P. Burke, None
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