Most patients enter the hospital expecting to be healed. Yet, each year more than 2 million people in the United States develop an infection during their hospital stay. These nosocomial infections are a leading cause of hospital deaths in the United States, killing nearly 100,000 people per year, and costing nearly $5 billion a year to treat.
So why isn’t more progress being made to reduce the incidence, mortality and enormous costs associated with nosocomial infections? The answer can partly be explained in a new study published in the Oct. 18 issue of the Annals of Internal Medicine.
Mark Rupp, M.D., professor of internal medicine at UNMC, was lead author of this nine-center study, which evaluated a new kind of central venous catheter (CVC) designed to help reduce nosocomial infections.
The CVC is placed in a major vein to draw blood and provide nutrition and medication to patients. The CDC estimates about 53 percent of adult patients in intensive care units have a CVC on any given day.
This study compared an antiseptic-coated CVC to an uncoated CVC in 780 intensive care unit patients. In patients receiving the coated catheters, the results showed a substantial decrease in bacterial colonization, the first step to an infection.
But the study revealed something with even broader implications, Dr. Rupp said. It suggested that meticulous infection-control measures used by hospital personnel could play an even greater role in reducing microbial infections than the catheter itself.
“Our infection rate was much lower possibly because we used good techniques and barriers,” Dr. Rupp said. “What this means is you don’t necessarily have to use coated catheters, you have to use appropriate precautions for inserting and caring for catheters.”
The Institute of Medicine contends that wider implementation of the nosocomial infection guidelines from the Centers for Disease Control and Prevention would save more than 40,000 lives annually, reduce infection rates by up to 50 percent and save nearly $2.75 billion.
“Our study clearly indicates the importance of using various precautions in insertion and care of central venous catheters,” Dr. Rupp said. “Infections of these devices result in nearly 250,000 cases of bloodstream infections per year. Patient safety is a big concern.”
Dr. Rupp’s study was funded by Arrow International Inc., which manufactures the antiseptic-coated catheter. He said investigator-initiated money to study nosocomial infections is nearly non-existent, yet these studies may provide additional proof that simple measures are more successful and far less costly than complex technologies in reducing hospital infections.
“Nearly 100,000 persons die each year from nosocomial infections,” Dr. Rupp said. “An effective hospital infection control program isn’t expensive compared to the huge expense, in terms of mortality, morbidity and economic cost, of health care-associated infections. As a nation, we spend much more money on issues like AIDS and bioterrorism even though, in comparison, they do not have as much impact on the average American as health care-associated infections. We just need to make prevention of these infections a bigger national priority.”