Preventing Infection

John Jernigan, Deputy Chief of the Prevention and Response Branch Division of Healthcare Quality Promotion for the Centers for Disease Control and Prevention, shares his thoughts on hospital-acquired infections and reveals why he is optimistic for the future.

“There is certainly a long way to go with regard to making our hospitals and other healthcare settings as safe as they can be”
-John Jernigan

Hospital or healthcare-acquired infections are a serious issue because they can be quite harmful and even life threatening to patients, and they increase the cost of healthcare. HAIs account for an estimated 1.7 million infections and 99,000 associated deaths every year in US hospitals.

The most common types of HAIs include urinary infections and bloodstream infections – often caused by the use of catheters, infections of surgical sites and pneumonia and also often associated with the use of artificial ventilators. 

HAIs are finally being recognized as an important safety problem and one that we can do something about. Over the past decade, there have been a number of advances in our understanding of the preventable fraction of healthcare-associated infections; that is, what proportion of these infections can be prevented by implementing certain prevention measures.

The CDC issues a series of specific recommendations for preventing these common types of infections. The cornerstone of prevention is proper attention to hand hygiene and other standard infection control precautions by healthcare personnel, including the use of gowns and gloves in certain settings. There are also a number of infection-specific prevention measures, such as procedure-specific techniques to be used when inserting and using urinary or bloodstream catheters or when performing surgical procedures.

There is certainly a long way to go with regard to making our hospitals and other healthcare settings as safe as they can be. Data from the National Healthcare Safety Network, a national HAI surveillance system operated by the CDC, suggests that infection rates for at least some infections have been declining in recent years; however, the rates for other types of infection – such as gastrointestinal infections – may be increasing.

Rarely, healthcare associated infections may be caused by problems with water contamination, such as Legionnaire’s disease. But more important is proper attention to standard precautions including hand hygiene and taking steps to prevent infections caused by invasive devices and procedures.

The SHEA/IDSA compendium represents an important complement to official CDC guidelines, providing a concise, easily applied distillation of current guidelines in a format that facilitates translation of official guidelines into practice. CDC guidelines are produced by mean of extensive systematic assessment of the quality and weight of evidence to support each recommendation while also allowing public scrutiny and comment. The SHEA/IDSA compendium is based on a nimble approach that relies on the judgment of individual reviewers, which allows rapid production and efficient consensus.

I am optimistic that we will continue to see advances in the prevention of HAIs in the next few years. Success creates success, and the stunning prevention successes we’ve witnessed by many hospitals in the last few years have inspired similar efforts nationwide. I believe this will translate into fewer infections and more lives saved.