Third-Year Student’s Study on Health Care-Associated Infections Published in New England Journal of Medicine

People regard hospitals as places of healing — which, of course, they are. Yet, according to a recent study published in the prestigious New England Journal of Medicine and co-authored by Samantha “Sammy” Greissman, M.P.H., a third-year student at the University of Miami Miller School of Medicine, health care–associated infections continue to be a major threat to the safety of patients.

A 2011 point-prevalence survey conducted in the U.S. showed that four percent of hospitalized patients had a health care–associated infection. The current study, based on a follow-up survey in 2015, assesses changes in the prevalence of health care–associated infections during a period of national attention to preventing them.

Rates of selected health care–associated infections have become state and national metrics by which government agencies and consumers evaluate health care quality in U.S. hospitals. The National Healthcare Safety Network of the Centers for Disease Control and Prevention tracks state and national progress in preventing health care–associated infections in thousands of health care facilities across the country.

“The good news is that the prevalence of such infections has actually declined, thanks to stringent infection-control protocols implemented by hospitals,” Greissman said.

In 2015, a total of 12,299 patients in 199 U.S. hospitals were surveyed, compared to 11,282 patients in 183 hospitals in 2011. Fewer patients had health care–associated infections in 2015 than in 2011 – 394 vs. 452 – largely owing to reductions in the prevalence of surgical-site and urinary tract infections.

Pneumonia, gastrointestinal infections (most of which were due to Clostridioides difficile), and surgical-site infections were the most common health care–associated infections, according to Greissman.

Overall, patients’ risk of having a health care-associated infection was 16 percent lower in 2015 than in 2011, after adjustment for age, presence of devices, days from admission to survey, and status of being in a large hospital.

Results were similar in an analysis restricted to 148 hospitals that participated in both surveys. Patients in the 2015 survey had a 22 percent lower risk of health care–associated infections than did those in the 2011 survey.

“Since 2011, efforts aimed at preventing health care–associated infections have continued to grow nationally, with a focus on antimicrobial-resistant pathogens,” Greissman said. “Such infections continue to pose a serious threat to patients, however, and hospitals need to enhance their prevention strategies against C. difficile infection and pneumonia.”

Alex J. Mechaber, M.D., Bernard J. Fogel Chair in Medical Education, senior associate dean for undergraduate medical education and professor of medicine, applauded Greissman’s work.

“It’s an outstanding accomplishment to have one’s work published in the New England Journal of Medicine—particularly for a third-year medical student,” Dr. Mechaber said. “Sammy is one of our emerging talents here at the Miller School, and we’re extremely proud of her.”

Greissman, who grew up in Broward County, graduated from Yale, where she majored in history of science, medicine, and public health, and also earned a master’s degree in public health in epidemiology of microbial diseases. She plans to specialize in infectious diseases and is particularly interested in working with the immunocompromised population, which includes transplant and cancer patients.

Tags: health care–associated infection, New England Journal of Medicine, Samantha Greissman