Preventing health care-associated infections is possible. Yet on any given day, these infections affect about 1 in 25 patients in U.S. hospitals. Furthermore, bacteria that defeat the drugs designed to kill them — a process known as antibiotic resistance — could return us to a time when even simple infections often proved fatal, and hospitals were a place to be avoided.
Today, antibiotic resistance causes more than 23,000 deaths and 2 million illnesses per year in the United States. Many cases begin while people are receiving health care.
The Centers for Disease Control and Prevention’s most current state-level report on health care-associated infections shows progress has been made preventing some life-threatening infections, and Georgia is heading in the right direction. However, much more work needs to be done.
For example, Georgia hospitals have cut in half the number of bloodstream infections among babies cared for in neonatal intensive care units. Surgical site infections from two common types of surgeries, colon surgery and abdominal hysterectomy, are now 17 percent and 14 percent lower than national levels. Georgia recently reported that bloodstream infections from central lines in intensive care units are 33 percent lower than the national level, but progress outside of ICUs is less marked.
Today in health care, six types of bacteria are about to defeat all drugs designed to treat them. If that happens, the risk of untreatable infection will make common surgical procedures, such as hip and knee replacements, far more dangerous. Dialysis patients could develop deadly bloodstream infections. Life-saving treatments that suppress the immune system, such as chemotherapy and organ transplants, could potentially cause more harm than good.
Better antibiotic prescribing practices, known as antibiotic stewardship, can protect today’s patients from infections caused by multi-drug-resistant superbugs, and can preserve lifesaving antibiotics for use by tomorrow’s patients. Our health care facilities are an important part of the solution to prevent growing drug resistance.
Last year, the Georgia Department of Public Health reached out to CDC to help it develop strategies for improving antibiotic prescribing practices. At first, about half of Georgia hospitals had committees addressing the issue, but few were taking specific actions. To rally hospital engagement, Georgia developed a recognition program that honors hospitals that meet its goals for antibiotic stewardship.
Georgia’s is now one of 10 state health departments within the CDC-funded Emerging Infections Program network of state health departments and academic medical centers. Georgia’s participation is important in answering critical questions about emerging health care-associated infection threats, including antibiotic resistance trends in the United States.
Georgia also is one of five locations in the U.S. implementing the federal Partnership for Patients initiative. Its Healthcare Engagement Networks engage hospitals across the country to improve patient safety and quality and achieve lower costs. As of April, 132 hospitals in Georgia were active members. These partners meet monthly, along with the Georgia Quality Improvement Organization (QIO), to ensure that partners coordinate activities and maximize benefits for patients. This team supports vigorous educational activities and other initiatives to help Georgia hospitals improve and maintain quality care and patient safety.
Additionally, a group of Georgia hospitals is participating in a nationwide project by the Agency for Healthcare Research and Quality to reduce catheter-associated urinary tract infections. The Georgia Hospital Association has recruited 52 units in 31 hospitals for the project. The units have put into practice a proven method to prevent such infections.
CDC depends on Georgia and all states to continue to work to eliminate health care-associated infections. As a Georgia patient, I am happy to see the Georgia Department of Public Health facilitating work to improve in-patient prescribing practices across the state and prevent these infections. This work is clearly paying off.
Dr. Denise Cardo is the director of the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, at the Centers for Disease Control and Prevention.
