CDC: Too Many Infections in Dialysis Clinics

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WASHINGTON—The number of central line bloodstream infections in hospital ICUs has plummeted; however, there are still too many infections occurring in dialysis units, according to a report from the Centers for Disease Control and Prevention (CDC).

Bloodstream infections in intensive care unit patients with central lines decreased by 58 percent in 2009 compared to 2001, according to a new CDC Vital Signs report.

"This reduction is the result of hospital, local, state and national medical and public health efforts focused on tracking infection rates and then using that information to tailor and evaluate prevention programs," said Denise Cardo, MD, director of CDC's Division of Healthcare Quality Promotion. "The report findings point to a clear need for action beyond ICUs. Fortunately, we have a prevention model focused on full collaboration that can be applied broadly to maximize prevention efforts."

During these nine years, the decrease represented up to 27,000 lives saved and $1.8 billion in excess healthcare costs, according to the CDC, which said bloodstream infections in patients with central lines can be deadly, killing as many as 1 in 4 patients who gets one.

In addition to the ICU findings, the report found that about 60,000 bloodstream infections in patients with central lines occurred in non-ICU health care settings such as hospital wards and kidney dialysis clinics. About 23,000 of these occurred in non-ICU patients (2009) and about 37,000 infections occurred in dialysis clinics patients (2008).

Infections are one of the leading causes of hospitalization and death for hemodialysis patients, according to the CDC. At any given time, about 350,000 people are receiving hemodialysis treatment for kidney failure. Seven in 10 patients who receive dialysis begin that treatment through a central line.

A central line is a tube usually placed in a large vein of a patient's neck or chest to deliver treatment in an intensive care unit, elsewhere in the hospital, and during dialysis. A bloodstream infection can happen when germs enter the blood through a central line, often because proper procedures were not used while the central line was placed or maintained.

The CDC said that in recent years, studies have proven that healthcare providers can prevent most bloodstream infections in patients with central lines by following CDC infection control recommendations, which include removing central lines as soon as medically appropriate. In hemodialysis patients, central lines should only be used when other options are unavailable.

"Preventing bloodstream infections is not only possible, it should be expected,” said Thomas R. Frieden, MD, MPH, CDC director. “Meticulous insertion and care of the central line by all members of the clinical care team including doctors, nurses and others at the bedside is essential. The next step is to apply what we've learned from this to other healthcare settings and other healthcare-associated conditions, so that all patients are protected.”

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