by Zack Moore, MD and Jennifer MacFarquhar, RN, MPH, CIC
Clostridium difficile (C. diff) and methicillin-resistant Staphylococcus aureus (MRSA) are both important public health problems, responsible for approximately 14,000 and 11,000 deaths in the United States each year, respectively. Both of these infections are frequently acquired in healthcare settings and have therefore been the target of many control efforts by hospitals working independently and in collaboration. These efforts have led to a 54% reduction in the number of invasive MRSA infections occurring during hospitalization between 2005 and 2011.1 However, the incidence of C. diff infections has continued to increase in recent years, as has the number of deaths attributed to C. diff in North Carolina.2,3
Beginning in January
2013, all acute care hospitals in North Carolina began reporting MRSA
bacteremia and C. diff LabID events through the CDC’s National Healthcare
Safety Network (NHSN). These
hospital-specific data were first made public on the Centers for Medicare and
Medicaid Services’ Hospital Compare website beginning in December 2013 and were
first included in the North Carolina Division of Public Health’s Healthcare-Associated
Infections Quarterly Report in January 2014.4,5
LabID event reporting
is based solely on laboratory results, and therefore some of the events
reported may not represent true infections. However, this method of reporting
has the advantages of being relatively more objective and less labor-intensive
than case-based reporting using clinical case definitions. Moreover, publication of these infection data provides an
opportunity to examine and understand the information on a statewide and
individual hospital level. In North Carolina, infection rates for the first
nine months since reporting began (January–September 2013) were within the
predicted range for both C. difficile
and MRSA bacteremia. Data from the first full year of reporting will be
published in the upcoming annual report, anticipated in April 2014.
Infections caused by both of these organisms are preventable.
Publication of these data highlights the excellent and ongoing work that
hospitals do to protect patients, and will hopefully lead to increased
attention and awareness of these important threats to patient safety.
1. Dantes R, Mu Y, Bellflower R et al. National Burden of
Invasive Methicillin-Resistant Staphylococcus
aureus Infections, United States, 2011. JAMA Intern Med. 2013; 173(21):1970–1978.
2. Lessa FC, Gould CV, McDonald LC. Current status of Clostridium difficile infection
epidemiology. Clin Infect Dis. 2012; 55 Suppl 2:S65–70.
3. North Carolina State Center for Health Statistics Vital
Records Report, available at http://www.schs.state.nc.us/data/vital.cfm. Accessed February 11, 2014.
