Tracking Down Infections

CURE, Summer 2013, Volume 12, Issue 2

Hospital infection rates have decreased, which is good news for cancer patients.

While targeting cancer with chemotherapy, radiation or surgery increases the probability of cure, it can also increase the risk of infection.

National rates for several types of hospital infections have declined since 2008, amid heightened public scrutiny, with one bloodstream infection plummeting by as much as 41 percent, according to 2011 data released earlier this year by the Centers for Disease Control and Prevention (CDC).

Patients can also check out infection rates at their own local hospitals by accessing the same CDC infection tracking system through the federal website Hospital Compare (medicare.gov/hospitalcompare). Cancer patients are considered more vulnerable to infection, when chemotherapy or other treatment temporarily suppresses their immune systems.

But the relevance of hospital infection rates, even if they prove high, is a matter of some dispute.

Lisa McGiffert, who directs the Safe Patient Project at Consumers Union, says current results provide a useful snapshot, even though only some infections are publicly reported. “This is still just the tip of the iceberg,” says McGiffert, whose non-profit group has long advocated for better public reporting. “But it is an indicator of the hospital’s record.”

Make sure hospital clinicians are washing their hands, and don't accept that an infection is "part of the deal" when it comes to hospital treatment

"Infections may not be among the most pressing worries of cancer patients," says John Birkmeyer, who directs the Center for Healthcare Outcomes and Policy at the University of Michigan in Ann Arbor.

“Whether I get a wound infection is not what I’m worried about,” Birkmeyer says. “I’m worried about whether I get discharged alive, and whether I’m going to be cured of my cancer,” he says. Research to date, he adds, hasn’t found any link between infections and these bottom-line outcomes. The federal disease center’s national analysis, published in February, identified the greatest decline in central line-associated bloodstream infections, down by 41 percent since 2008. Surgery-related infections, as well as urinary tract infections linked to catheter use, also have decreased—by 17 percent and 7 percent, respectively. The findings are based on 2011 reporting by more than 11,500 facilities to the CDC’s infection tracking system, called the National Healthcare Safety Network.

For interested patients, more hospital data will soon be released. This past January, hospitals started reporting two other dangerous infections, Clostridium difficile and Methicillin-resistant Staphylococcus aureus (MRSA) to the CDC. The related results for individual hospitals will be released through Hospital Compare in late 2013 or early 2014, according to CDC spokeswoman Abbigail Tumpey.

The Hospital Compare website provides data on the numbers of infections at each hospital, as well as how they compare to state and national benchmarks, using a number called the Standardized Infection Ratio. The closer that figure is to zero, the better the hospital’s record, according to a primer issued by the Consumers Union on how to understand the hospital data.

How can patients reduce their personal vulnerability? Make sure hospital clinicians are washing their hands, and don’t accept that an infection is “part of the deal” when it comes to hospital treatment, McGiffert says.

“So when people [hospital clinicians] say, when you’re having surgery, that there’s a risk of infection, you should respond, `What are you going to do to eliminate that risk for me?’”