Surgical Site Infections Linked to Increased Mortality, Study Finds

The results of a new study show that patients with a surgical site infection (SSI) are more likely to experience increases in mortality and long-term infection risk.

The retrospective observational cohort study, published in JAMA Surgery, examined whether an infection contracted during the first 30 days following a surgical procedure was associated with increased incidence of mortality and infection during the roughly 11 months that followed (postoperative days 31 to 365).

The study included nearly 660,000 veterans undergoing major surgery through the Veterans Health Administration from January 2008 to December 2015. As the researchers note, at any given point between postoperative days 31 to 365, patients who experienced postoperative infection during the initial 30 postoperative days had a 1.9-fold higher risk of mortality and 3.2-fold higher risk of one-year infection compared with those patients without a 30-day infection.  

Among these patients, about 3.6% had a 30-day infection, about 6.6% had a long-term infection and about 3.8% died during follow-up. The most frequent types of postoperative infection were urinary tract infection, skin and soft tissue infection, bloodstream infection, pneumonia or a simultaneous combination of multiple infection types.

The researchers conclude, "Preventive efforts in the first 30 days postoperatively may improve long-term patient outcomes."

CDC Publishes 2018 Healthcare-Associated Infection Progress Report

The Centers for Disease Control and Prevention (CDC) has published its 2018 Healthcare-Associated Infection Progress Report. The report provides year-to-year progress (2017 to 2018) on the prevention of key healthcare-associated infections (HAIs) in acute care hospitals, long-term acute care hospitals and inpatient rehabilitation facilities.

The HAI Progress Report consists of national and state-by-state summaries of HAIs across the settings. More specifically, it provides data from the National Healthcare Safety Network on central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), surgical site infections (SSIs), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream events and Clostridioides difficile (C. difficile) events. 

While progress was achieved in some areas, more significant improvements are needed in others.

National highlights from the 2018 HAI Progress Report include the following:

• Acute Care Hospitals: Significant decrease in CLABSIs, CAUTIs and C. difficile infections. No significant change in MRSA bacteremia, abdominal hysterectomy SSIs, colon surgery SSIs and VAEs.

• Long-Term Acute Care Hospitals: Significant decrease in CAUTIs, MRSA bacteremia and C. difficile infections. No significant change in VAEs.

• Inpatient Rehabilitation Facilities: Significant decrease in C. difficile infections. No significant change in CLABSIs, CAUTIs and MRSA bacteremia.

Working toward the reduction and eventual elimination of HAIs should be a priority of all healthcare organizations. Data indicates that on any given day, about 1 in 31 hospital patients has at least one HAI. They lead to the preventable loss of tens of thousands of lives and cost the U.S. healthcare system billions of dollars annually.

First Influenza-Associated Pediatric Deaths Reported This Flu Season

The Centers for Disease Control and Prevention (CDC) has reported the first pediatric influenza deaths of the new flu season.

The two deaths were documented in CDC's "Weekly U.S. Influenza Surveillance Report."

The deaths occurred the week ending October 12. CDC notes that one death was associated with an influenza A virus for which no subtyping was performed and one death was associated with an influenza B/Victoria virus.

The latest CDC FluView report, for the week ending October 19, indicated that while seasonal influenza activity in the United States increased slightly, it remains low. About 1.7% of visits to a healthcare provider were for influenza-like illness. While such illness is higher than the previous week, it remains below the national baseline of 2.4%. Louisiana and Puerto Rico are experiencing high influenza-like illness activity. While a majority of the country is reporting sporadic or local flu activity, the viruses are widespread in Maryland and regional in Louisiana.

We may now be in influenza season, but it's not too late to get your flu shot. The CDC recommends that everyone six months of age and older should get an influenza vaccine every season with rare exception.

Concerning when to get vaccinated, CDC states the following:

"Because the timing of the onset, peak and end of flu seasons varies from year to year and cannot be predicted, it is difficult to say when is the best time to be vaccinated for any one season. In trying to balance the need to get many people vaccinated before flu activity begins with concerns about potential waning of vaccine-induced immunity during the flu season, CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that vaccination be offered by the end of October.

"Children six months through eight years of age who need two doses should receive their first dose as soon as possible after the vaccine becomes available to allow the second dose (which must be administered at least four weeks later) to be received by the end of October.

"For people who need only one dose for the season, vaccinating early – for example, in July or August –may lead to reduced protection against flu later in the season, particularly among older adults. While vaccination should optimally occur before the onset of flu activity in the community, providers should continue to offer and encourage vaccination as long as flu viruses are circulating and unexpired vaccine is available. To avoid missed opportunities for vaccination, vaccination can be offered during routine health care visits and hospitalizations."

CDC, ACIP and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. healthcare workers get vaccinated annually against influenza.

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