Health & Medicine

Annual report highlights risk of hospital-acquired infections

Hospitals often have an air of squeaky-clean sterilization, even while infections spread within their walls.

A Consumer Reports analysis released Wednesday highlighted the struggle to reduce the prevalence of hospital-acquired infections including MRSA, C. difficile and urinary tract infections at several of Sacramento’s most used facilities.

Each hospital’s ability to reduce infections was rated on a scale of one to five, falling above, below or on par with a national reduction standard set by the Centers for Disease Control and Prevention.

▪ Kaiser Permanente Sacramento Medical Center was rated well below the standard for avoiding infections overall, and for avoiding urinary tract infections caused by catheters. It was substantially lower than the standard for avoiding surgical site infections and cases of a bowel condition called C. difficile.

Kaiser’s South Sacramento Medical Center received the lowest rating for urinary tract and surgical site infections, and the second lowest rating for C. difficile and for avoiding infections overall.

▪ The Mercy hospitals included in the survey (General, Folsom, San Juan), generally ranked in the second-lowest category for avoiding infections, achieving slightly above the standard for infection prevention in a few categories.

▪ The six Sutter hospitals surveyed showed the greatest success in avoiding infections, achieving the highest, second highest or middle ratings in most categories. Sutter Auburn Faith was rated in the second-lowest category for surgical site infections, and Sutter Roseville received a similarly low rating for C. diff.

▪ The UC Davis Medical Center was rated slightly above the national standard in most categories with the exception of MRSA prevetion.

▪ Most of the hospital systems ranked in the two highest categories for avoiding central line infections.

About 650,000 patients each year develop a hospital acquired infection, according to the data. The CDC reports that one of every 25 hospitalized patients becomes infected while in the hospital.

The infections come at a cost. A 2013 study in the JAMA Internal Medicine Journal found that hospitals spend $10 billion per year fighting hospital-acquired infections.

Common causes of hospital-acquired infections include inadequately sterilized equipment, failure to follow hospital safety protocols, poor hospital layout and improper administration of antibiotics. Patients who are older or have suppressed immune systems are more likely to acquire infections while in the hospital.

At UC Davis, staff is vigilant about hand hygiene, both for caregivers and patients, said Dr. Doug Kirk, chief medical officer for the medical center. They take extra precautions before and after surgeries and avoid using catheters in cases where the device is not absolutely necessary.

Even so, a lengthy stay in a facility makes some patients especially vulnerable to hospital-acquired infections.

“It’s just because they’re so sick, they have so many interventions, and they’re so critically ill that you’re going to see those types of bugs,” Kirk said. “It’s an ongoing battle.”

Barbara Crawford, vice president for quality and regulatory services at Kaiser Permanente Northern California, said physicians, nurses and housekeeping use a joint approach to try to reduce patient infections. The hospital has focused additional efforts on reducing C. difficile infections and has seen a significant decrease over the last year, she said.

“We make sure that patients are placed in the location and environment that are most appropriate for their condition,” Crawford said in an email. “Hand hygiene, sophisticated testing, thorough disinfection and careful stewardship around antibiotic use are the pillars of Kaiser Permanente’s successful and widely emulated programs to control both community and hospital-acquired infections."

Brooke Burgess, Dignity Health spokeswoman, said the report “does not necessarily reflect today’s care delivery.”

“We value transparency and we will continue to intensify our efforts to provide the best possible care for our community,” she said.

A Sutter Health spokesman offered a brief comment, saying the issue was something people at the system “work hard at.”

Sammy Caiola: 916-321-1636, @SammyCaiola