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THE PROBLEM

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The Problem: Research & Statistics

 

Xenex’s scientific staff continually monitors research on healthcare associated infections worldwide. Here are some of the key statistics and research studies that highlight the problem:

 

Burden of Healthcare Associated Infections (HAIs)
  • Healthcare associated infections are currently the fourth leading cause of death in the United States and cost the healthcare system more than $30 billion each year. HAIs cause more deaths each year than breast cancer, AIDS, and automotive accidents combined. This equates to the crash of a commercial 747 airliner every day.
  • At least 5% of people receiving treatment in hospitals are infected each year (Mitka, 2008)
  • Some estimate that up to 10% of inpatients contract infections from the hospital (Bad Bugs, No Drugs, 2004)
  • 87% of medical facilities do not take the recommended steps to prevent infections (Mitka, 2008)
  • More than two million HAIs occur each year (Mitka, 2008)
  • 98,000 deaths per year are due to HAIs (Mitka, 2008)
Cost of Infections
  • Healthcare associated infections add an average of $15,000 to a patient’s bill – over $40 billion a year total (Mitka, 2008)
  • Vancomycin-resistant enterococcus (VRE) infections cost $33,251 (attributable cost), VSE infections cost $21,914. (Pelz et al., 2002)
  • C. difficile infections added $3.2 billion to the cost of treating hospital patients in 2005 (O’Brien, Lahue, Caro, & Davidson, 2007)
  • Staph infections (MSSA and MRSA) cost 14.5 billion in 2003 (Noskin et al., 305)
  • A survey of 55 hospitals with below average infection rates showed that the costs of HAIs wiped out in-patient hospital profits (McCaughey, 2008)
  • Medicare and Medicaid have a policy of refusing to reimburse health care facilities for certain preventable infections. Private insurance is following this lead. (Mitka, 2008)
Role of Hospital Environment
  • Only 38% of health care workers follow hand washing guidelines correctly (Mitka, 2008)
  • Nurses’ gloves were infected 42% of the time from touching surfaces in a patient room. (APIC presentation, 2008)
  • Prior environmental contamination, whether measured via environmental cultures or prior room occupancy by VRE-colonized patients, increases the risk of acquisition of VRE. (Drees et al., 2008)
  • Monitored cleaning performance using an invisible fluorescent targeting method, and rooms (14 high-touch objects) were marked and evaluated after terminal cleaning. 1,119 rooms and 13,369 objects were evaluated in 23 hospitals.
  • Results: Mean proportion of objects cleaned was 49%.
  • Conclusion: There is substantial opportunity for improving terminal cleaning/disinfecting activities.
  • A study of 113 surfaces in an operating theater and hospital wards over a 14-day period showed that 76% of these surfaces had unacceptable levels of microbes after cleaning and 61% of operating theaters were unacceptable. (Griffith, Cooper, Gilmore, Davies, & Lewis, 2000)
  • 16% of hospital room surfaces remained VRE-contaminated after routine terminal cleaning (Byers et al., 1998)
  • In 23 acute care hospitals, only 49% of surfaces evaluated were actually cleaned after a terminal clean. (Carling et al., 2008)
  • Evaluation of 2320 objects in 197 patient areas found that terminal cleaning cleaned only 57.1% of the surfaces/objects; less than 30% of bedpan cleaners, toilet area handholds, doorknobs and light switches were cleaned (Carling, Von Beheren, Kim, & Woods, 2008)
  • 94% of VRE patient occupied rooms tested positive for contamination before cleaning and 71% tested positive after cleaning. 100% of (C. difficile-associated disease) CDAD rooms tested positive before cleaning and 78% tested positive after cleaning. (B. C. Eckstein et al., 2007)
Impact of Cleaning on Infection Rate and Cost
  • C. difficile incidence data correlated significantly with the prevalence of environmental C. difficile. (Fawley & Wilcox, 2001)
  • 31% of people coming into contact with C. difficile patients tested positive for C. difficile, including 14% of healthcare personnel. 58% of C. difficile patient rooms were widely contaminated. (Samore et al., 1996)
  • MRSA can survive 11 days on a chart, 9 days on a laminated table top and 9 days on a polyester curtain. (R. Huang, Mehta, Weed, & Price, 2006)
  • Being admitted to a room in which the prior occupant had MRSA or VRE increases your chances of getting MRSA or VRE by 40%. (S. S. Huang, Datta, & Platt, 2006)
  • Newly-acquired MRSA increased ICU stay by 11.8 days and newly-acquired VRE increased ICU stay by 10.5 days. (S. S. Huang et al., 2006)
  • Seven out of eight healthcare workers who were MRSA carriers had infected their home in one study. (Kniehl, Becker, & Forster, 2005)
  • 40% of MRSA-positive healthcare workers transferred the infection to the home environment. (Eveillard, Martin, Hidri, Boussougant, & Joly-Guillou, 2004)
  • Of 1697 ICU patients, 11.1% acquired MRSA and 14.2% acquired CR-GNB (ceftazimine-resistant gram negative bacteria) (Ho, 2003)
  • 27% of door handles in a university hospital were MRSA and/or MSSA contaminated. (Oie, Hosokawa, & Kamiya, 2002)
  • 27% of surfaces tested in MRSA-infected or colonized patient rooms were contaminated with MRSA. Environmental contamination occurred in 73% of infected patient rooms and 69% in colonized patient rooms. 42% of personnel with no direct patient contact had contaminated their gloves with MRSA from touching surfaces. (Boyce, Potter-Bynoe, Chenevert, & King, 1997)
  • Enhanced cleaning reduced VRE transmission on one burn unit by 26-24%. Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures. Hayden MK, Bonten MJ, Blom DW, Lyle EA, van de Vijver DA, Weinstein RA.
General Research
  • Gloved hands can transfer virus to door knobs, faucets and other common fixtures. (Boone & Gerba, 2007)
  • VRE survival on countertops is 5-7 days; bedrails 24 hours; telephones 60 min; stethoscopes 30 min; gloved and ungloved hands >60 min (APIC presentation, 2008)
  • A person touches his/her mouth, eyes, ears or nose 1-3 times every 5 minutes (Boone & Gerba, 2007)
  • 80% of infectious diseases are transferred by touch, meaning person-to-person or surface-to-person (Boone & Gerba, 2007)
  • Cleaning cloths and rags cross-contaminate surfaces. (Boone & Gerba, 2007)
  • “Interrupting disease spread via indoor fomite is one of the more practical methods for limiting or preventing enteric and respiratory viral infections.” (Boone & Gerba, 2007)
  • 11 in 46 patients MRSA colonized or infection. (APIC 2007 Survey).
  • Enhanced infection control saved $189,318 (net savings) in an adult oncology unit (Montecalvo MA, Jarvis WR Cost savings associated with infection control measures)
  • The attributable cost of VRE care in an ICU is $33,251. VRE control strategies that cost less than $304 dollars per day are cost-effective (Pelz RK, Lisett PA infections in the ICU)
  • Enhanced cleaning reduced VRE rates by 26-34% Hayden, CID 2006
  • HAIs reduced overall net patient margins by $5,018 per infected patient (Dispelling the Myths)
  • HAIs added 227,000 extra patient days in Pennsylvania in 2005 (Dispelling the Myths)


Sources
  • Bad Bugs, No Drugs. (2004). Infectious Disease Society of America.
  • Boone, S. A., & Gerba, C. P. (2007). Significance of fomites in the spread of respiratory and enteric viral disease. Applied and Environmental Microbiology, 73(6), 1687-96. doi: AEM.02051-06.
  • Boyce, J. M., Potter-Bynoe, G., Chenevert, C., & King, T. (1997). Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America, 18(9), 622-7. doi: 9309433.
  • Byers, K. E., Durbin, L. J., Simonton, B. M., Anglim, A. M., Adal, K. A., & Farr, B. M. (1998). Disinfection of hospital rooms contaminated with vancomycin-resistant Enterococcus faecium. Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America, 19(4), 261-4. doi: 9605276.
  • Carling, P. C., Parry, M. F., & Von Beheren, S. M. (2008). Identifying opportunities to enhance environmental cleaning in 23 acute care hospitals . Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America, 29(1), 1-7. doi: 10.1086/524329.
  • Carling, P. C., Von Beheren, S., Kim, P., & Woods, C. (2008). Intensive care unit environmental cleaning: an evaluation in sixteen hospitals using a novel assessment tool. The Journal of Hospital Infection, 68(1), 39-44. doi: S0195-6701(07)00375-1.
  • Drees, M., Snydman, D. R., Schmid, C. H., Barefoot, L., Hansjosten, K., Vue, P. M., et al. (2008). Prior Environmental Contamination Increases the Risk of Acquisition of Vancomycin-Resistant Enterococci. Clinical Infectious Diseases, 46(5), 678-685. doi: 10.1086/527394.
  • Eckstein, B. C., Adams, D. A., Eckstein, E. C., Rao, A., Sethi, A. K., Yadavalli, G. K., et al. (2007). Reduction of Clostridium Difficile and vancomycin-resistant Enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods. BMC Infectious Diseases, 7, 61. doi: 1471-2334-7-61.
  • Eveillard, M., Martin, Y., Hidri, N., Boussougant, Y., & Joly-Guillou, M. (2004). Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America, 25(2), 114-20. doi: 14994935.
  • Fawley, W. N., & Wilcox, M. H. (2001). Molecular epidemiology of endemic Clostridium difficile infection. Epidemiology and Infection, 126(3), 343-50. doi: 11467790.
  • Ho, P. (2003). Carriage of methicillin-resistant Staphylococcus aureus, ceftazidime-resistant Gram-negative bacilli, and vancomycin-resistant enterococci before and after intensive care unit admission. Critical Care Medicine, 31(4), 1175-82. doi: 12682490.
  • Huang, R., Mehta, S., Weed, D., & Price, C. S. (2006). Methicillin-resistant Staphylococcus aureus survival on hospital fomites. Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America, 27(11), 1267-9. doi: ICHE2004237.
  • Huang, S. S., Datta, R., & Platt, R. (2006). Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Archives of Internal Medicine, 166(18), 1945-51. doi: 166/18/1945.
  • Kniehl, E., Becker, A., & Forster, D. H. (2005). Bed, bath and beyond: pitfalls in prompt eradication of methicillin-resistant Staphylococcus aureus carrier status in healthcare workers. The Journal of Hospital Infection, 59(3), 180-7. doi: S0195670104002622.
  • Mayfield, J. L., Leet, T., Miller, J., & Mundy, L. M. (2000). Environmental control to reduce transmission of Clostridium difficile. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 31(4), 995-1000. doi: 11049782.
  • McCaughey, B. (2008). Unnecessary Deaths: The Human and Financial Costs of Hospital Infections. (p. 70). Committee to Reduce Infection Deaths.
  • Mitka, M. (2008). Public, Private Insurers Refusing to Pay Hospitals for Costs of Avoidable Errors. JAMA, 299(21), 2495-2496. doi: 10.1001/jama.299.21.2495.
  • Noskin, G. A., Rubin, R. J., Schentag, J. J., Kluytmans, J., Hedblom, E. C., Jacobson, C., et al. (305). National Trends in Staphylococcus aureus Infection Rates: Impact on Economic Burden and Mortality over a 6-Year Period (1998-2003). Clinical Infectious Diseases, 45(9), 1132-1140. doi: 10.1086/522186.
  • Oie, S., Hosokawa, I., & Kamiya, A. (2002). Contamination of room door handles by methicillin-sensitive/methicillin-resistant Staphylococcus aureus. The Journal of Hospital Infection, 51(2), 140-3. doi: 12090803.
  • Pelz, R. K., Lipsett, P. A., Swoboda, S. M., Diener-West, M., Powe, N. R., Brower, R. G., et al. (2002). Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: attributable costs and outcomes. Intensive Care Medicine, 28(6), 692-7. doi: 12107672.
  • Samore, M. H., Venkataraman, L., DeGirolami, P. C., Arbeit, R. D., & Karchmer, A. W. (1996). Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. The American Journal of Medicine, 100(1), 32-40. doi: 8579084.

 

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The actual financial and infection rate impact of Xenex disinfection services on a particular healthcare facility may vary. Our system has been proven to significantly reduce microbial contamination in the healthcare environment, which studies show will result in a decrease in the risk of healthcare associated infections and their associated costs. However, a number of variables specific to the healthcare facility – including current infection rates, target microorganisms, facility and patient operations characteristics – will determine the actual financial savings and infection rate reduction. Please contact a Xenex representative at 1-800-553-0069 to learn more about how our service works and the guarantees we offer.

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