MichiganState-WideHealthcare-AssociatedInfecConSurveillance
MichiganDepartmentofHealthandHumanServices,SHARPUnit
AllisonChan,AllisonGibsonMurad,MPH,Dr.JennieFinks,DVM,MVPH
SIRTRENDS
OBJECTIVE
1.)ToassesstheprogressofHAItrendsforthestateof
Michigan.2.)Tou.lizeaggregatedatafrom2014totarget
improvementsandweaknessesinHAIpreven.onmeasures.
BACKGROUND
Figure2.
MICLABSIs
are
significantly
lessthan
expected.
BACKGROUND
Healthcare-AssociatedInfec.ons(HAIs)areinfec.onsthat
pa.entsobtainwhilereceivingcarefromahealthcare
facility.Theyareasignificantcauseofmorbidityand
mortalityintheUnitedStates.ThecosttotreatHAIsis
burdensometona.onwidehealthcarecosts.
TheSurveillanceforHealthcare-AssociatedInfec.onsand
ResistantPathogens(SHARP)Unitwasfoundedin2009
andresideswithintheMichiganDepartmentofHealth&
HumanServices(MDHHS).TheSHARPUnitconductsHAI
state-widesurveillanceviatheNa.onalHealthcareSafety
Network(NHSN).
Figure3.
TheCMSrequiresallacutecarehospitals,somecri.cal
accesshospitals,somelongtermacutecaretoreport
variousHAIdatatotheCMS.Michiganprac.ces
voluntarydatasharingbetweenhealthcarefacili.esand
theSHARPUnit.Facili.esarestronglyencouragedto
sharetheirNHSNdatawithSHARPdespitenomandate.
Therearecurrently
104hospitalsoutof
168thatcurrently
sharetheirNHSN
datawithSHARP.
Figure1.
Therearecurrently104
hospitalsoutof168that
sharetheirNHSNdatawith
SHARP.
Figure5.
MICAUTIs
are
significantly
morethan
expected.
SIR=StandardInfec.on
Ra.o
Figure4.
orsta.s.callysignificantlyaboveorbelowanSIRof1,respec.vely
oraboveorbelowanSIRof1,respec.vely
Figure6.
MRSAratesaredecreasing
MRSAbacteremiaratesremainconsistent
CDIratesareincreasing
DEVICE-ASSOCIATEDINFECTIONRATESANDRATIOS
Figure7.
MISSIsare
lessthan
expected.
TypesofHAIs:centralline-associatedbloodstreaminfec.ons(CLABSIs),catheterassociatedurinarytractinfec.ons(CAUTIs),surgicalsiteinfec.ons(SSIs),
ven.lator-associatedevent(VAE),methicillin-resistantStaphylococcusaureus
(MRSA),andClostridiumdifficile(CDI).
METHODS
LABIDEVENTRATES
Figure8.
*SIR=StandardInfecConRaCo
Ra.oofobservedevents
comparedtothenumberof
predictedevents,accoun.ngfor
unittypeorprocedure.AnSIRof1
canbeinterpretedashavingthe
samenumberofeventsthatwere
expected.AnSIRthatisbetween0
and1representsfewerevents
thanpredicted,whileanSIRof
greaterthan1representsmore
eventthanexpected.
CONCLUSIONS
STRATIFIEDRESULTS
Teachingornon-teaching:TeachinghospitalshadaCAUTISIRof
1.145(p<0.0001).Non-teachinghospitalshadaCAUTISIRof0.732
(p=0.0273).CLABSIandMDROSIRswereallbelowtheexpected
valueof1.
<200bedsor>200beds:LargerhospitalsshowedaCDISIRof0.886
(p=0.011)andsmallerhospitalshadaMRSASIRof0.869(p=0.018).
BothsizeshadsignificantlylowerCLABSISIRsthanexpectedbut
smallerhospitalsshowedaCAUTISIRof1.256(p<0.0001).
REFERENCES
2014AnnualReportReportofHealthcare-AssociatedInfec.onsinMichiganHospitals.MichiganDepartmentofHealth&HumanServices,
Healthcare-AssociatedInfec.onsinMichigan.MichiganDepartmentofCommunityHealth,SurveillanceforHealthcare-Associated
SurveillanceforHealthcare-AssociatedandResistantPathogens(SHARP)Unit.
andResistantPathogens(SHARP)Unit.WebAccessedOct.5th.www.michigan.gov/hai
WebAccessedSeptember,21st.www.michigan.gov/hai
HAIscon.nuetooccurinMichiganhealthcarefacili.esandthusremainaconcern.The
reduc.onofHAIsisfeasiblewiththefocusonpreven.onini.a.vesandeduca.onal
awareness.Overall,thenumberandratesofCLABSIshavebeensignificantlyreducedsince
theintroduc.onoftheCLABSIchecklistbytheMHAKeystoneCenterforPa.entandSafety
&Quality.AggregateCAUTIlevelsaresignificantlyaboveexpected,MRSAandCDIrates
havedecreasedandincreased,respec.vely,butrecentlyshowaslightplateaufrom2013.
ACKNOWLEDGEMENTS
ThemembersoftheSHARPUnitandtheDivisionofCommunicableDiseasesatMDHHS.
TheCer.ficateinHealthcareInfec.onPreven.on&Control(CHIP)programatthe
UniversityofMichiganSchoolofPublicHealth.