Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida.
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.


METHODS
Point prevalence survey.


METHODS
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 ([Formula: see text]), urinary tract infections ([Formula: see text]), pneumonia ([Formula: see text]), and bloodstream infections ([Formula: see text]) 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.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. smagill@cdc.gov
Shelley S
SS
Magill
Walter
W
Hellinger
Jessica
J
Cohen
Robyn
R
Kay
Christine
C
Bailey
Bonnie
B
Boland
Darlene
D
Carey
Jessica
J
de Guzman
Karen
K
Dominguez
Jonathan
J
Edwards
Lori
L
Goraczewski
Teresa
T
Horan
Melodee
M
Miller
Marti
M
Phelps
Rebecca
R
Saltford
Jacquelyn
J
Seibert
Brenda
B
Smith
Patricia
P
Starling
Bonnie
B
Viergutz
Karla
K
Walsh
Mobeen
M
Rathore
Nilmarie
N
Guzman
Scott
S
Fridkin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D006306:Health Surveys; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D055815:Young Adult
D000890:Anti-Infective Agents