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Prof. Dr. Alessandro Pontes-Arruda, LL.B., MD, MSc, PhD, FCCM, Baxter Healthcare
Mr. Tom Polen, Group President, BD
on behalf of
AdvaMed HAI Reduction Task Force
15 August 2014, Beijing, PRC
Infection Prevention and Control /
Healthcare-Associated Infections (HAIs)
Infection Prevention and Control /
Healthcare-Associated Infections (HAIs)
HAI occur throughout the world, affecting hundred of millions of
patients each year, causing increased morbidity, mortality and cost1
90% of HAI deaths in the US are caused by multi-drug resistant organisms
(MDRO). Of the 15 most prevalent MDROs, 8 are acquired primarily in
healthcare settings2.
After 5 years of worldwide surveillance (2002-2007) it is clear that the
incidence of CVC-BSI in developing economies (the main type of HAI) is at
least 3-fold higher as compared to EU or USA (9.2 vs. 2.4 per 1,000 catheter
days)3
The attributable cost per CVC-BSI range from $56,167-$71,443 per
episode4
It has been estimated that 65-70% of HAI are preventable by implementing
evidence-based interventions5
1 WHO. The burden of health care-associatedinfection worldwide: A summary 2010.
2 US Health and Human Services. Health-careassociatedinfections.
3 RosenthalV.D. et al. Am J Infect Control 2008. 36 (9):627-637
4 Dimick J.B. et al. Arch Surg 2001, 136(2):229-234
5Umscheid et al. Infect Control Hosp Epidemiol. 2011.
HAIs: A Worldwide and Preventable Problem
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Asia-Pacific BSI Length of Stay and Cost
United States1 China 2 Phillipines3
Extra Mortality 22.6% 14% 3.2%
Extra Length of Stay 17 days 15 days 11.6 days
Extra Costs per
episode $81,208 - -
1. Song X et al. Infect Control Hosp Epidemiol 2003. 24(4):251-256
2. Hu B et al. Am J Infec Control 2013. 41(4):301-306
3. Navoa-Ng JA et al. Am J Infec Control 2011. 39(7)548-554
HAI leads to prolonged hospital/ICU stay, taking up bed space and requiring additional use of
medications (including broad spectrum and usually more expensive antibiotics)
Treating preventable HAI is therefore an inefficient allocation of scarce resources. Prevention would
be a more proactive and efficient allocation
Avoiding costs and suffering to systems and patients – many of whom are vulnerable
Economic and Health Costs of HAIs to
Healthcare Systems & Patients
Financial Losses due to HAI are Significant: In Europe HAI is estimated to cost €7 billion.
In the US estimates range from $6.5 – 30 billion. Little economic analysis has been conducted
in developing countries, however, available cost estimates suggest that HAI are a considerable
financial burden.
Transition to Tom
Belo Horizonte, Brazil,
1992 -HAI burden
estimated
at US$ 18M.
Argentina ICU: CRBSI and
VAP estimated at US$4,888
& US 2,255 per case.
Mexico: Cost of
single HAI episode
was US$ 12,155.
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Infection Prevention & Control, HAIs and Anti-Microbial
Resistance (AMR) are Linked
Infection
Prevention and
Control Measures
Healthcare
Associated
Infection (HAI)
Control
Anti-microbial
Stewardship and
Control of AMR
• Poor infection control is the key driver of healthcare-associated infections.
• Inappropriate antimicrobial use is the key driver of resistance. This includes:
overuse of antibiotics; misuse due to lack of accurate diagnosis; and non-
compliance due to inaccurate diagnosis and lack of access and compliance with
treatment protocols.
Prevention, accurate diagnosis, and appropriate treatment
are all essential to preventing HAIs and AMR.
Strengthening Infection Control: A Policy Action Road Map to
Combat HAIs, MDROs and Antimicrobial Resistance
Investment in infrastructure and capacity to
prevent, detect & manage infection, including:
Surveillance, analysis and reporting of HAIs,
organisms of concern & patterns of AMR
Adequate numbers of trained personnel
(infection control, infectious disease,
microbiology and pharmacy)
Essential laboratory infrastructure and
services
Alignment of financial incentives with better
health outcomes
Commitment to awareness and transparency
Development of guidelines, targets & measures
Prevention, Detection &
Management are the pillars of
effective infection control
Surveillance systems provide
the foundation for awareness
and action
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HAIs are preventable with existing evidence-based strategies
Successes has been demonstrated in variety of resource settings
The Path Forward
HAIs, MDROs and Antimicrobial Resistance are closely linked, pose a significant threat to
health and are a source of avoidable waste.
Build on existing APEC
initiatives.
1
Leverage the power of
public-private
partnerships, to:
• access knowledge, skills &
resources
• enhance efficiency
• share risk
• spread improvement
3
Promulgate policy to
encourage development
of effective infection
control in all member
economies.
2
