Archive Infection Control 2018

On Point

No More Excuses

Charles Cook

Charles Cook, MD, FACS, FCCM


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DOWN TO ZERO New thinking is needed to eliminate the risks of surgical infections.

You prep skin, disinfect surfaces, decontaminate instruments, warm patients and administer antibiotics, and yet avoidable surgical site infections continue to occur at incredible cost to patients and the healthcare system. Infected patients experience personal suffering, pain, loss of income, reduced quality of life and possibly even death. Individual surgical site infections cost about $20,785 to treat, making them the third most costly healthcare-acquired infection (HAI) behind only central line-associated bloodstream infections ($45,814) and ventilator-associated pneumonia ($40,144), according to a recent study in JAMA Internal Medicine (

Readmission and extended lengths of stay are driving the exorbitant costs of SSIs, and those costs are only increasing. Prolonged hospitalizations also double the risk of mortality in patients with SSIs, and that risk is even greater for the elderly, who are becoming a larger segment of the patient population.

The JAMA study says the annual economic burden of surgical, central line, Clostridium difficile, ventilator-associated and catheter-associated urinary tract infections (CAUTIs) is $9.8 billion, with SSIs contributing the most (33.7%) to the overall expense. Treatment of CAUTIs cost less than 1% of the total burden, yet much more energy and effort has been made to eliminate them than to reducing SSI rates.

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