Hospitals seeing significant declines in pediatric hospital infections

Infants and babies are significantly less likely to acquire infections in the hospital than they were just a few years ago, yielding significant savings in healthcare spending, according to a study.

Hospital-associated infection rates decreased by more than half among U.S. neonatal and pediatric ICUs from 2007 to 2012, the study found. The reductions led to $131 million in savings, the study estimates. Hospital-driven efforts to become safer by reducing infections are working, but the success should not stop hospitals from aiming for zero, researchers say.

“Hospitals and physicians are getting the message,” said Dr. Stephen Patrick, an assistant professor of pediatrics and health policy at Vanderbilt and lead author of the study, published this week in the journal Pediatrics. “It's good news,” he said.

The study looked at hospital-associated infection rates reported to the CDC's National Healthcare Safety Network by 173 neonatal ICUs and 69 pediatric ICUS in 39 states, between Jan. 1, 2007, and Sept. 30, 2012. Researchers found a substantial reduction in both central line-associated bloodstream infections (CLABSI) and ventilator-associated pneumonias (VAP) among critically ill young patients during the five-year window.

Incidence of CLABSI decreased from 4.9 per 1000 central-line days in 2007, to 1.5 per 1000 in 2012. Rates of ventilator-associated pneumonias decreased from 1.6 to 0.6 per 1000 ventilator days during that period. Overall in neonatal ICUs, there was a 61% drop in incidence rates of CLABSI and 50% drop for VAP.

Among pediatric ICUs, rates of CLABSI decreased from 4.7 per 1000 central-line days in 2007, to 1.0 per 1000 central-line days in 2012. VAP rates decreased from 1.9 to 0.7 per 1000 ventilator-days during that time. Overall in pediatric ICUs, there was a 61% drop in incidence rate for CLABSI and a 76% reduction in VAPs.

The study estimated reductions in CLABSI helped neonatal ICUs save $61 million and pediatric ICUs save $70 million. Cost-saving estimates associated with VAP could not be drawn, Patrick said. The total saving might be underestimated, he said.

“The magnitude of the decrease is surprising and heartening,” said Patrick, who attributes the improvements to increased national focus on preventable conditions in hospitals over the past 10 to 15 years. “But I think we still have to aim toward zero.… That way we can continue the progress made,” he said.

During a Senate hearing in July, safety leaders pointed to improvements in reducing hospital-associated conditions as one success in making hospitals safer. But they also emphasized the need for more reliable data, metrics and monitoring systems that can help paint a clearer national picture. Providers have made great strides in particular areas, some of them testified, but have not considerably raised the overall quality of care.

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