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2021 National and State Healthcare-Associated Infections (HAI) Progress Report Shows Increases in Some HAIs

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CDC released the 2021 National and State Healthcare-Associated Infections Progress Report, which shows significant increases in the standardized infection ratio (SIR) between 2020 and 2021 in some HAIs for some facility types.

Changes in SIRs among acute care hospitals from 2020 to 2021 include:

  • 14% increase in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia
  • 12% increase in ventilator-associated events (VAE)
  • 11% increase in surgical site infections (SSIs) following abdominal hysterectomy
  • 7% increase in central line-associated bloodstream infections (CLABSI)
  • 5% increase in catheter-associated urinary tract infections (CAUTI)
  • 3% decrease in C. difficile infection

In 2021, many hospitals continued to face extraordinary circumstances due to the COVID-19 pandemic that may have reduced the implementation of standard infection prevention and control (IPC) practices. In acute care hospitals, the increases seen in some HAIs in 2021 contrast with the success in reducing these infections prior to the pandemic. Despite the challenges of the COVID-19 pandemic, acute care hospitals performed significantly better than the 2015 national baseline in preventing CLABSI, CAUTI, SSIs following colon surgeries, and C. difficile infections.

The report includes data submitted to CDC’s National Healthcare Safety Network (NHSN) across four healthcare settings: acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, and long-term acute care hospitals. There are three comparison measures in the report:

  • Comparing 2021 state SIR to 2015 national baseline SIR of 1
  • Comparing 2021 state SIR to 2021 national SIR (excludes the state’s data from national data for independent comparison)
  • Comparing 2021 SIR to 2020 SIR (the state or nation is compared to itself between 2020 and 2021 national comparisons between 2020 and 2021)

The SIR is a summary statistic that can be used to track HAI prevention progress over time; lower SIRs are better. In addition to the SIRs, the report includes the standardized utilization ratios (SURs), which measure device use by comparing the number of observed device days to the number of predicted device days.

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