Hospital acquired infection/Health care acquired infection

Affects more than 2 million hospitalized patients annually and costs more than 6 billion in excess charges.

Healthcare-associated infections (HAIs) are responsible for many deaths of hospitalized patients each year.

It is estimated that 1.6 to 3.8 million healthcare associated infections occur in US nursing homes annually, leading to an estimated 150,000 hospital admissions and as many as 380,000 deaths.

Nursing home residents are at higher risk for healthcare associated infections, due to their older age, wounds, medical devices, and coexisting medical conditions.

Patients with prolonged hospitalization are at high risk for HAIs.

On any given day, about 1 in every 25 hospital patients contracts an infection.

Patients acquire health care–associated infections in about 4% of hospital stays nationwide.

Estimated annual direct medical costs of healthcare associated infections ranges from 28-$45 billion in US hospitals, with about one in every 20 inpatients developing an infection related to their hospital care (Scott RD).

Estimated 1.7 million hospital acquired infections occurred in 2002, about 4.5 per 100 admissions, and almost 99,000 deaths (Klevens RM).

Health care associated infections are the most common complications of hospital care, affecting approximately one in every 20 inpatients. 6th leading cause of death in the US.

Health care associated infections are associated with increased hospital length of stay, increased costs, and increased rates of death.

Health care associated infections are estimated to be 50% preventable.

A recent survey in 2011 found 4% of inpatients in US acute care hospitals had at least 1 health care associated infection: estimate of 648,000 inpatients with an approximate 721,000 such infections (Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Study).

In the above study 25.6% of all health care associated infections were device associated.

Estimated 440,000 health care associated infections annually among adult US inpatients.

Health care acquired/associated infections approximately $9.8 billion annual costs.

Over one third of costs due to surgical site infection, ventilator associated pneumonia, and catheter associated UTI.

The skin of hospitalized patients is a reservoir for pathogens and invasion by skin flora is thought to be a mechanism that contributes to healthcare-associated infections.

Among leading causes of such infections are those related to central venous catheters.

Most commonly associated with invasive medical devices or surgical procedures.

Healthcare workers acquire bacteria on their hands and clothing by touching patients.

Overall infection rate approaches 40% and may be as high as 80% in patients admitted to the ICU for more than 5 days.

More than one third of such infections may be preventable (Yokoe DS).

Acquired lower respiratory infections and blood stream infections are most lethal.

Urinary tract infections are the most common acquired hospital infections.

Gram negative bacteria associated with about 30% of hospital acquired infections.

Gram negative organisms predominate in ventilator associated pneumonia(47%), and urinary tract infections (45%)(Hidron AI).

Health care workers acquire bacteria on the hands and clothing by touching patients.

Hand hygiene compliance is low.

Use of gloves and gowns reduces acquisition of antibiotics susceptible and antibiotic resistant bacteria by healthcare workers and decrease subsequent transmission to other patients.

Daily bathing with chlorhexidine impregnated washcloths reduces the risk of acquisition of multi drug resistant organisms and the development of hospital acquired bloodstream infections (Climo MW et al).

Daily bathing with chlorhexidine decreases skin colonization with multi drug-resistant organisms, decreases the rates of bloodstream infections and reduces Clostridia difficile infections.

Chlorhexidine is a broad-spectrum topical antimicrobial agent that may decrease the bacterial burden, reducing infections when used to bathe the skin.

Use of contact precautions by wearing gloves and gowns for all patient contact may decrease acquisition of antibiotic resistant bacteria and health care associated infections.

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