Healthcare-Associated Infections: Study Finds Super-Bugs Hitchhike on Health Care Providers
Healthcare-associated infections (HAI) are a threat to patient safety. Prevention and reduction of healthcare-associated infections is a top priority for the U.S. Department of Health and Human Services (HHS). HAIs–infections patients can obtain while receiving medical treatment in a healthcare facility–are a major, yet often preventable, threat to patient safety. Although significant progress has been made in preventing some infection types, there is much more work to be done. In 2014, results of a project known as the HAI Prevalence Survey were published. That survey described the burden of HAIs in U.S. hospitals, and reported that, in 2011, there were an estimated 722,000 HAIs in U.S. acute care hospitals. Additionally, about 75,000 patients with HAIs died during their hospitalizations. More than half of all HAIs occurred outside of the intensive care unit.
On any given day, about one in 25 hospital patients has at least one healthcare-associated infection. A recent study found that dangerous bacteria, including super-bugs such as methicillin-resistant Staphylococcus aureus (MRSA), can spread from sick patients to others in a hospital on the clothing (scrubs) worn by health care providers. These pathogens can also find their way from the patient to items in their hospital room, such as the bed rails.
A recent study tracked the spread of these bacteria; the researchers looked at hospitalized patients in their study. These patients received care from nurses over the course of three separate 12-hour shifts in the intensive care unit. The nurses used a new set of scrubs for each shift. Twice a day, the researchers sampled the nurses’ scrubs, the patients’ rooms and the patients themselves for bacteria. In total, they took more than 2,100 samples from the nurses’ scrubs (including the sleeves, the pockets and the midriffs of the scrubs), 455 samples from the patients and nearly 3,000 samples from the patients’ rooms (including the supply cart, the bed and the bed rails). Then, they tested these samples for bacteria. By identifying the specific strains of the bacteria, the researchers determined when there had been a transmission of bacteria, from one location to another, within the rooms. The study found instances of bacterial transmission: some of these instances of transmission were from patient to nurse, some were from room to nurse and some were from patient to room. The researchers noted that the pockets and sleeves of the nurses’ scrubs were the parts of the clothing that were the most likely to be contaminated, and the bed rails were the most likely places in the room to be contaminated.
Six types of bacteria were transmitted, including MRSA, Klebsiella pneumoniae, bacteria from a group called the Acinetobacter baumanii complex and methicillin-susceptible Staphylococcus aureus (MSSA), a bacterium that is like MRSA but is treatable with the antibiotic methicillin. Bacteria were found in rooms no matter what time of day the samples were taken, even though the rooms were cleaned daily.
Steps can be taken to control and prevent HAIs in a variety of settings. Research shows that when healthcare facilities, care teams and individual doctors and nurses are aware of infection problems, and take specific steps to prevent them, rates of some targeted HAIs (e.g., CLABSI) can decrease by more than 70 percent. This makes health care communication of utmost importance. Efforts for improved health communication must be prioritized. Preventing HAIs is possible, but it will take a conscious effort of everyone–clinicians, healthcare facilities and systems, public health, quality improvement groups and the federal government working together toward improving care, protecting patients and saving lives.
Other suggestions offered in the recent study to help stop the spread of such infections in hospitals included:
- Health care providers must wash their hands after interacting with a patient
- Health care providers must use disposable gloves and gowns when treating patients with certain infections
- Health care provision rooms should be cleaned meticulously and regularly
Download a copy of the HHS Action Plan to Prevent Healthcare-Associated Infections, providing a roadmap for HAI prevention in acute care hospitals.