Date: November 24th, 2014
Healthcare-associated infections (HAI) are deadly. Some estimate that these infections kill up to 70,000 people each year. They are also expensive. HAIs cost the U.S. healthcare system as much as $33 billion annually.
Earlier this fall, with support from Cubist, the Alliance for Aging Research brought together an amazing group of leaders from the fields of aging, infectious disease, health care and government to discuss the disproportionate impact of healthcare-associated infections (HAI) on older adults and the need for an improved treatment paradigm to address infections in this vulnerable population. This group of thought leaders heard presentations from leading experts in the area of HAI prevention and public policy and explored possible solutions to improve infection prevention, increase awareness and education, and encourage the development of new antibiotics.
It was apparent from our forum that both policy and culture need to change.
Focus on ALL Care Settings
There is limited information available on infection rates in nursing homes, but available data suggest that between one and three million infections occur in this setting. Programs to direct the appropriate use of antibiotics (known as stewardship programs) are already established in many hospitals. Information on infection rates in hospitals is also publicly available. Stewardship programs are almost non-existent in long-term care facilities, nursing homes and in home care delivery. Furthermore, there is no transparency on infection rates in these increasingly popular settings of care.
Preliminary surveillance data from the Centers for Disease Control and Prevention (CDC) indicate that nearly 75 percent of cases of one deadly infection called C.Difficile occur outside of a hospital. Almost 50 percent of these C.Difficile infections are in people receiving healthcare in their community. These numbers tell us that we need a different approach to preventing infections across the continuum of care. We also need to take action to promote antibiotic stewardship in all settings where the elderly receive care.
Cause for Hope
The President’s Council of Advisors on Science and Technology (PCAST) released a report in September that makes a number of recommendations to strengthen antibiotic stewardship. Of particular note, the Council called for the Centers for Medicare and Medicaid Services (CMS) to institute regulations by 2017 for long‐term care facilities and nursing homes requiring robust antibiotic stewardship programs as a condition of participation. This recommendation was given some momentum when the Alliance for Aging Research joined with 33 other organizations to urge the CMS’ administrator to adopt this PCAST recommendation.
This is cause for hope. Requiring stewardship as a condition of participation in Medicare has been effective in encouraging behavior change in other healthcare settings, but there must also be emphasis placed on tracking and reporting infections rates in people receiving care in nursing homes, long-term care facilities and home care. Improved monitoring and reporting of infections will allow the right interventions to be put in place to prevent infections, and it will also give older adults the information required to make better choices on where to receive their care.
You Can Help
You should contact your member of Congress and senators early in January 2015 and ask them to commit to meaningful policy to reduce healthcare associated infections among our seniors. The next Congress could provide new opportunities to advance solutions that improve infection prevention, increase awareness and education, and encourage the development of new antibiotics to address resistant infections.
Also, most people do not know that they can take steps to combat the spread of antibioticresistant infections by reducing their own unnecessary antibiotic use. Colds, the flu, most sore throats and bronchitis are caused by viruses, not bacteria. Antibiotics do not help fight viruses and taking antibiotics when you have a virus may do more harm than good. Unnecessary use of antibiotics can increase your risk of getting an infection that resists antibiotic treatment. If you or a loved one you care for is prescribed an antibiotic, you might want to ask your healthcare provider if it is really necessary. You can learn more about appropriate use of antibiotics through the CDC’s Get Smart community.