organ transplant are at a much higher risk of developing an HAI or sepsis.
Why is Sepsis So Common in Hospitals?
Sepsis is the body’s immune response to infection, most commonly caused by bacteria. The chemicals released into the bloodstream to combat infection restrict blood flow and cause inflammation. Rather than fighting the infection, the overwhelming response leads to oxygen deprivation in the organs, a drop in blood pressure, and can lead to multiple organ failures.
In hospitals, sepsis is often caused by an underlying infection or bacteria that has been introduced into the body during the course of medical care. Some of the most common causes of sepsis in hospitals include:
Also called central venous catheters or intravenous catheters (IV), central lines are one of the most common causes for HAIs and sepsis in hospitals. Central lines are inserted into large veins in the neck, chest, or groin areas, and depending on the condition being treated, the line may remain in place for several days or weeks, or even months. Because central lines are inserted into major veins and are kept in place for longer durations, the risk of infection and serious complications are higher.
Urinary Tract Infections
Many hospital patients require the use of a urinary catheter. This catheter is inserted into the urethra, and serves as a drain for urine during hospitalization. Urinary catheters are a common cause of infections, including the common catheter-associated urinary tract infection, or CAUTI. These are the most common HAI occurring in hospitals, with at least 75 percent of all UTIs occurring in hospitals being classified as a CAUTI.
Surgical Site Infections
Surgical site infections are a common risk factor in hospitals. Any time surgery is performed, there is a chance of bacteria entering the body. During recovery, there are also further opportunities for bacteria to move into the wound if it is not properly cleaned, covered, and taken care of. Surgical site infections are called SSIs, and can easily develop into sepsis or septic shock. Bloodstream infections, including sepsis, following surgery occur at a rate of 5.23 percent, meaning that more than five percent of all surgical patients will develop an infection.
Patients who need help breathing may be placed on a ventilator. Ventilators have tubes that run down the throat and into the airway. The machine helps expand and retract the lungs and helps the patient breathe easier. Unfortunately, ventilators have been known to increase the risk of pneumonia. Ventilator tubes may provide an avenue for bacteria to travel into the lungs. Pneumonia, as a bacterial infection, is a common cause of sepsis in hospitals.
Strategies to Prevent HAIs and Sepsis in Hospitals
Due to some of the concerning rates of HAIs in U.S. hospitals, the CDC has initiated a series of prevention strategies. These strategies use surveillance, laboratory research, and outbreak investigations to develop improved prevention techniques. The CDC offers healthcare providers with toolkits and other information about how to prevent HAIs and protect providers and patients from infection. The CDC has specific guidelines for infection control and prevention, including:
- Disinfection and sterilization
- Hand hygiene
- Proper handling of laundry
- Environmental infection control
- Isolation precautions
- Multidrug-resistant organisms (MDRO)
- Catheter-associated urinary tract infections (CAUTI)
- Organ transplantation
- Surgical site infection (SSI)
- Dialysis infection control
- Disease/organism-specific infection control guidelines:
- Tuberculosis (TB)
The U.S. Department of Health and Human Services (HHS) has also developed a committee dedicated to the prevention of HAIs and sepsis in hospitals. The HHS Steering Committee for the Prevention of Healthcare-Associated Infections began in 2008 and continues offer support for prevention strategies and healthcare education. The Committee developed a National Action Plan to Prevent Healthcare-Associated Infections: Road Map to Elimination, which includes the following:
- Phase