1. CDC Winnable Battles: Preventing Healthcare-Associated Infections (HAIs)
National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion

2. Medical Therapeutics Standard
16) Assess the differences between healthcare-associated infections and non-healthcareassociated infections using examples drawn from mock patient documents or case studies. Support explanations with relevant surveillance statistics, preventive measures, and methodologies concerning outbreak detection, management, and education.

3. Videos https://www.youtube.com/watch?v=5rpep33F6lE

4. Healthcare-Associated Infections (HAIs)

5. Antibiotic resistance in the United States
Sickens >2 million people/year
Kills at least 23,000 people/year
Plus 15,000 per year from C. difficile
>$20B/year in health care costs
Threatens modern medicine
Loss of effective antibiotic treatment could make routine infections deadly
Patients who receive specialized care will be at highest risk
Need to act now or even drugs of last resort will soon be ineffective

6. Antibiotic Resistant Threats in the U.S.
CDC’s AR Report ranked 18 drug-resistant threats: Urgent, Serious, and Concerning
Many of these AR threats are causes of healthcare-associated infections
Urgent threats include
Carbapenem-resistant Enterobacteriaceae (CRE)
Clostridium difficile
Serious threats include
Drug-resistant Pseudomonas
Methicillin-resistant Staphylococcus aureus
Access CDC’s AR Report at

7. Federal and State Alignment of HAI/AR Programs
CDC Winnable Battle
National Plans and Goals
HHS HAI Action Plan and HHS Agency Priority Goal
National Strategy and Action Plan for Combating Antibiotic-Resistant Bacteria (CARB)
CMS Value-based Purchasing
State Legislation and HAI/AR programs

8. States with Mandatory Public Reporting Policies for Healthcare-Associated Infections (HAIs)
DC*
2004
2016
2004 – 4 states
2016 – 38 states and DC
States with legislation for HAI reporting

9. CDC’s National Healthcare Safety Network (NHSN)
NHSN: Tracking infections in over 19,000 healthcare facilities nationwide
NHSN is used by
Facilities across healthcare to track HAIs and antimicrobial resistance, and direct prevention activities
States for public reporting and regional prevention
CMS for quality reporting and prevention initiatives
HHS to measure national progress
18,000 is the number of active reporting facilities. If we want to use the enrollees number, would change to 19,000 and tweak the language

10. healthcare-associated infections: 2008-2014
Progress reducing
healthcare-associated infections:
Version using CLABSI, SSI, and MRSA SIRs
*CLABSI: Central line-associated bloodstream infections
†MRSA: Methicillin-resistant Staphylococcus aureus, reduction since 2011

11. HAI Progress Report Based on 2014 data; published March 2016
National summaries of healthcare-associated infections in acute care hospitals
50% decrease in CLABSI between and 2014
17% decrease in SSIs related to the 10 select procedures tracked in the report between 2008 and 2014
No change in CAUTI between 2009 and 2014, but 5% decrease from 2013 to 2014
13% decrease in hospital-onset MRSA bacteremia between 2011 and 2014
8% decrease in hospital-onset C. difficile infections between 2011 and 2014
Added 2014 info and link to report. Does not include LTACH/IRF info. Will draft up separate slide can use if needed.
Source:

12. HAI Progress Report Based on 2014 data; published March 2016
National summaries of healthcare-associated infections in long-term acute care hospitals (LTACHs) and inpatient rehabilitation facilities (IRFs)
LTACHs
9% decrease in CLABSI in LTACHs between 2013 and 2014
11% decrease in CAUTI in LTACHs between 2013 and 2014
IRFs
14% decrease in CAUTI in IRFs between 2013 and 2014
2014 LTACH/IRF info slide
Source:

13. Targeting → Assessment → Implementation
Using CDC’s NHSN Data for Action: Targeted Assessment for Prevention (TAP) Strategy
Targeting → Assessment → Implementation
Identify healthcare facilities with excess infections
Assess gaps in infection prevention in targeted facilities/units using CDC tools
Implement interventions to address gaps in infection prevention using CDC Implementation Guidance
Partner among health departments and hospital networks with CDC and clinical expertise to prevent infections

14. Healthcare, infections, and antibiotic resistance have moved beyond hospitals

15. State HAI/AR Prevention Programs
CDC supports HAI/AR Programs in every state through the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement
State health departments work with state hospital associations, CMS-funded networks, and hospital networks to:
Track infections in healthcare facilities
Focus HAI prevention efforts using CDC’s NHSN data
Implement prevention strategies across healthcare settings using CDC’s tools and evidence-based guidelines

16. State HAI/AR Prevention Programs: Detect, Prevent, Respond
Expand the core capacity in all 50 states to detect, respond to, protect against HAI/AR threats
Across all healthcare settings, networks of facilities in up to 25 states working with health departments to:
Prevent infections
Improve prescribing

17. CDC Modeling Predicts Growth of Drug-Resistant Infections and C
CDC Modeling Predicts Growth of Drug-Resistant Infections and C. difficile Can Be Curbed With Coordinated Prevention Approach
Public health departments track and alert health care facilities to drug-resistant outbreaks in their area and the threat of germs coming from other facilities, and
Health care facilities work together and with public health authorities to implement shared infection control actions to stop the spread of antibiotic- resistant germs and C. difficile between facilities.
Access CDC Vital Signs at

18. CDC Recommends All Hospitals Implement Antibiotic Stewardship Programs
Access CDC Vital Signs at

19. Actions State Health Departments Can Take to Advance Antibiotic Stewardship
Gain an understanding of antibiotic stewardship activities in the state or area
Facilitate efforts to improve antibiotic prescribing and prevent antibiotic resistance
Provide educational tools to facilities to help prescribers improve practices
Promote CDC core elements for antibiotic stewardship programs

20. CDC Recommends Doctors and Nurses Combine Efforts to Protect Patients from HAI/AR Threats
Prevent the spread of bacteria between patients
Prevent infections related to surgery and/or placement of a catheter
Improve antibiotic use through stewardship
Access CDC Vital Signs at

21. Innovations to Improve Patient Safety: CDC Prevention Epicenters Program
CDC collaborates with academic investigators to conduct innovative infection control and prevention research
Fills prevention knowledge gaps identified by CDC’s outbreak response and surveillance data

22. Emerging Infections Program (EIP) Early Warning System for New and Changing Threats
CDC funds network of 10 state health departments collaborating with local health departments, academic institutions, other federal agencies, laboratories, infection preventionists, and healthcare providers
Conducts surveillance and special studies on HAIs and AR to assess overall burden and prevention impact across all healthcare facilities
Recently released 2011 HAI and Antimicrobial Use Prevalence Survey
Estimated 722,000 HAIs in US hospitals in 2011, or 1 in 25 patients
Estimated 75,000 patients with HAIs died during hospitalization

23. CDC’s Clinical and Environmental Microbiology Laboratory
Serves as national and an international reference laboratory for testing and diagnostic capacity of pathogens causing HAIs and antibiotic resistant infections
Develops and evaluates methods to reliably detect emerging antimicrobial resistance
Conducts applied research on improved detection methods for HAIs
Provides environmental microbiology methods for measuring contamination of healthcare environment
Assists in healthcare-associated outbreak investigations

24. Antibiotic Resistance Patient Safety Atlas
Includes open and interactive data about HAIs caused by antibiotic-resistant bacteria
Makes HAI AR data reported to CDC’s NHSN accessible
Provides awareness about antibiotic resistance patterns at national, state, and regional levels
Users can create customized visualizations or download raw data for further exploration
Shows percent resistance for 31 bug-drug combinations
Percent resistance (%R) metric shows the number of HAIs reported that were caused by resistant bacteria
Data was reported to CDC by 4,000+ healthcare facilities from 2011 to 2014
Includes urgent and serious resistance threats identified in CDC’s AR Threat Report

25. CDC’s AR Solutions Initiative
Detect and Respond
50-state lab capacity to track and stop the nightmare bacteria, carbapenem-resistant Enterobacteriaceae (CRE)
Robust systems to track resistance, antibiotic use, infections in the community and healthcare
AR Lab Network for nationwide detection of new and known threats
Prevent
Strategies to prevent HAI and AR spread in all healthcare settings
State prevention programs to drive adoption of the coordinated approach
Education, prevention for antibiotic stewardship and sepsis prevention
Innovate
Discover new ways to protect patients from resistant infections
AR Isolate Bank to support new drug and diagnostic development
Microbiome research to unlock mysteries of the gut-drug relationship

26. For more information: www.cdc.gov/winnablebattles
National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion