Reduce HAIs by up to 55%

Systematically implemented evidence-based infection prevention and control strategies can reduce healthcare associated infections (HAIs) by up to 55%.

This is according to a review of 144 studies published in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA). The study suggests that there is considerable room for improvement in infection prevention and control practices, regardless of the economic status of the country.

“Our analysis shows that even in high-income countries and in institutions that supposedly have implemented the standard-of-care infection prevention and control measures, improvements may still be possible,” said Dr Peter Schreiber, the study’s lead author and a researcher from the Division of Infectious Diseases and Hospital Epidemiology at the University Hospital of Zurich. “Healthcare institutions have a responsibility to improve quality of patient care and reduce infection rates by effectively implementing customised multifaceted strategies and improve patient outcomes.”

Researchers from University Hospital Zurich and Swissnoso, the Swiss National Center for Infection Control, reviewed 144 studies published around the world between 2005 and 2016 to determine the proportion of HAIs prevented through infection control interventions in different economic settings.

All the papers included in the analysis studied efforts designed to prevent at least one of the five most common healthcare-associated infections using a combination of two or more interventions — such as education and surveillance or preoperative skin decolonisation and preoperative changes in the skin disinfection protocol.

The interventions consistently produced a 35–55% reduction in new infections. The largest effect was for prevention of central line-associated bloodstream infections. Other infections studied were catheter-associated urinary tract infections, surgical site infections, ventilator-associated pneumonia and healthcare-associated pneumonia.

“Healthcare-associated infections come at a considerable expense to patients and families, but also cost the US healthcare system an estimated $9.8 billion each year,” said Dr Keith Kaye, MPH, President of the SHEA and a healthcare epidemiologist who was not involved in this study. “There have been tremendous advancements in developing strategies to prevent and control HAIs. This study demonstrates a need to remain vigilant in identifying and maintaining key infection control processes to ensure they can be optimally used to prevent infections, which in some cases are life-threatening.”

The group of studies analysed included controlled and uncontrolled before-and-after studies, randomised controlled trials, cluster-randomised control trials and a time-series analysis. Limitations of the study include that most of the studies analysed were not blinded trials — and therefore could be biased — and that smaller trials with negative results may have remained unpublished.

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