State report shows hospitals’ progress against infections

California hospitals registered a 10-percent decrease last year in a deadly kind of health care-acquired infection that can strike critically ill patients who must be fed or medicated with catheters, according to a new report released today by the state Department of Public Health.

The drop in central line infections, the highest-profile target for infection control officials nationwide, appears to mirror trends across the country, state officials write in a series of reports that tally cases of four types of infections during 2011 at nearly 400 hospitals statewide. State officials have also compiled an interactive map where consumers can look up rates for their local hospitals.

The state’s public release of once-private data reflects ballooning concerns nationwide about patients being sickened in the very hospitals charged with curing them. Such infections kill an estimated 13,500 California hospital patients each year, according to a 2009 state report. That's more than four times the number of people killed annually in state traffic accidents.

Many hospitals have fought infections by mandating check lists to assure that doctors and nurses wash their hands, wear gowns and follow other strict rules to protect patients during surgery or when inserting catheters.

News in the latest state report is mixed. Some major teaching hospitals continue to wrestle with high rates of central line infections among certain critical care patients, including Arrowhead Regional Medical Center in Colton, Community Regional Medical Center in Fresno, Los Angeles County Harbor-UCLA Medical Center near Torrance and UC Davis Medical Center.

But overall, hospitals statewide reported 3,163 cases of line infections in 2011, down from 3,519 cases a year earlier.

Three major teaching hospitals scored better-than-average rates for line infections among critical care patients: Cedars-Sinai Medical Center in Los Angeles, Santa Clara Valley Medical Center in San Jose and Stanford Hospital in Stanford. 

Some hospitals that launched major anti-infection campaigns have lowered their rates, including Riverside County Regional Medical Center in Moreno Valley, which fared poorly in the state’s first report in December 2010 but now rates better than the state average among medical/surgical critical care patients.

At the same time, rates have risen for hard-to-fight MRSA, or Methicillin-resistant Staphylococcus Aureus, at certain long-term acute care hospitals despite reduced or stable rates at many teaching and community hospitals, state officials write. They found a similar trend for Vancomycin-resistant Enterococci, or VRE, at some long-term care facilities, including Kindred Hospital Los Angeles and Promise Hospital of San Diego, where VRE rates were notably higher than the state rate. UC Davis Medical Center and Arrowhead Regional Medical Center each have MRSA rates higher than the state average for major teaching hospitals, according to the report. 

MRSA and VRE organisms are both resistant to certain antimicrobial drugs, and can cause serious bloodstream infections.

This is the third report produced under a 2008 state law requiring the public reporting of certain infections by all general acute-care hospitals in California. Known as "Niles' Law," the legislation, sponsored by state Sen. Elaine Alquist, D-Santa Clara, was spearheaded by Riverside County resident Carole R. Moss after her 15-year-old son, Niles, died of MRSA.

“These reports expand our knowledge of these dangerous infections and will ultimately result in better and safer care through increased awareness,” said Dr. Ron Chapman, the state health department's director, in a prepared statement. “CDPH will continue working with hospitals throughout California to improve HAI surveillance, prevention, and lower their infection rates.”

The new reports, which also contain data on surgical site infections, can be found on the website of the state health department.