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Prevalence of Healthcare-Associated Infections in Acute Care Hospitals in Jacksonville, Florida

Published online by Cambridge University Press:  02 January 2015

Shelley S. Magill ,
Walter Hellinger ,
Jessica Cohen ,
Robyn Kay ,
Christine Bailey ,
Bonnie Boland ,
Darlene Carey ,
Jessica de Guzman ,
Karen Dominguez  and
Jonathan Edwards
...Show all authors
Shelley S. Magill*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Walter Hellinger
Affiliation:
Mayo Clinic, Jacksonville, Florida
Jessica Cohen
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Atlanta Research and Education Foundation, Decatur, Georgia
Robyn Kay
Affiliation:
Florida Department of Health, Jacksonville, Florida
Christine Bailey
Affiliation:
Wolfson Children's Hospital, Jacksonville, Florida
Bonnie Boland
Affiliation:
Baptist Medical Center Downtown, Jacksonville, Florida
Darlene Carey
Affiliation:
University of Florida/Shands Hospital, Jacksonville, Florida
Jessica de Guzman
Affiliation:
Baptist Medical Center Beaches, Jacksonville, Florida
Karen Dominguez
Affiliation:
St. Vincent's Medical Center, Jacksonville, Florida
Jonathan Edwards
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Lori Goraczewski
Affiliation:
Mayo Clinic, Jacksonville, Florida
Teresa Horan
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Melodee Miller
Affiliation:
Orange Park Medical Center, Orange Park, Florida
Marti Phelps
Affiliation:
St. Vincent's Medical Center, Jacksonville, Florida
Rebecca Saltford
Affiliation:
Baptist Medical Center South, Jacksonville, Florida
Jacquelyn Seibert
Affiliation:
Mayo Clinic, Jacksonville, Florida
Brenda Smith
Affiliation:
Mayo Clinic, Jacksonville, Florida
Patricia Starling
Affiliation:
Baptist Medical Center Beaches, Jacksonville, Florida
Bonnie Viergutz
Affiliation:
St. Luke's Hospital, Jacksonville, Florida
Karla Walsh
Affiliation:
Baptist Medical Center Downtown, Jacksonville, Florida
Mobeen Rathore
Affiliation:
Wolfson Children's Hospital, Jacksonville, Florida University of Florida, Jacksonville, Florida
Nilmarie Guzman
Affiliation:
University of Florida, Jacksonville, Florida
Scott Fridkin
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, MS A-24, Atlanta, GA 30333 ([email protected])
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Abstract

Objective.

To determine healthcare-associated infection (HAI) prevalence in 9 hospitals in Jacksonville, Florida; to evaluate the performance of proxy indicators for HAIs; and to refine methodology in preparation for a multistate survey.

Design.

Point prevalence survey.

Patients.

Acute care inpatients of any age.

Methods.

HAIs were defined using National Healthcare Safety Network criteria. In each facility a trained primary team (PT) of infection prevention (IP) staff performed the survey on 1 day, reviewing records and collecting data on a random sample of inpatients. PTs assessed patients with one or more proxy indicators (abnormal white blood cell count, abnormal temperature, or antimicrobial therapy) for the presence of HAIs. An external IP expert team collected data from a subset of patient records reviewed by PTs to assess proxy indicator performance and PT data collection.

Results.

Of 851 patients surveyed by PTs, 51 had one or more HAIs (6.0%; 95% confidence interval, 4.5%–7.7%). Surgical site infections (n = 18), urinary tract infections (n = 9), pneumonia (n = 9), and bloodstream infections (n = 8) accounted for 75.8% of 58 HAIs detected by PTs. Staphylococcus aureus was the most common pathogen, causing 9 HAIs (15.5%). Antimicrobial therapy was the most sensitive proxy indicator, identifying 95.5% of patients with HAIs.

Conclusions.

HAI prevalence in this pilot was similar to that reported in the 1970s by the Centers for Disease Control and Prevention's Study on the Efficacy of Nosocomial Infection Control. Antimicrobial therapy was a sensitive screening variable with which to identify those patients at higher risk for infection and reduce data collection burden. Additional work is needed on validation and feasibility to extend this methodology to a national scale.

Infect Control Hosp Epidemiol 2012;33(3):283-291

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 3 , March 2012 , pp. 283 - 291
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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Footnotes

a.

Present affiliations: Mayo Clinic, Jacksonville, Florida (D.C.); Tanner Medical Center, Villa Rica, Georgia (L.G.).

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