The Healthcare-Associated Infections (HAI) Program
The Healthcare-Associated Infections (HAI) Program is part of the Infectious Disease Program in the Section of Epidemiology. HAIs are infections that patients acquire while receiving treatment for medical or surgical conditions. About 1 in 20 hospitalized patients in the US will contract an HAI. Each year in the US, these infections cost billions of dollars and contribute to the deaths of nearly 100,000 patients. Although they are often preventable, HAIs may have devastating medical, emotional, and financial consequences.
What does the State HAI Program do?
The HAI Program has a plan that describes our work and goals. Below is a brief summary of some of our ongoing projects and areas of interest:
The Alaska Infection Control and Prevention Advisory Council (AK-ICPAC) was created in 2009. It is a multidisciplinary group representing professionals in infectious disease, infection prevention, quality improvement, clinical pharmacy, microbiology, education, public health, and includes a health care consumer. AK-ICPAC works to coordinate HAI prevention efforts across the state, and to find collaborative solutions to infection prevention problems in Alaska.
Epidemiology Bulletin: Alaska Launches a Health Care-Associated Infections Prevention Program
The HAI Program is part of the Alaska Antimicrobial Stewardship Collaborative (A2SC), an organization that promotes optimal and appropriate use of antibiotics across Alaska. The HAI Program assists with A2SC projects. Additionally, the HAI Program conducts its own projects to support stewardship programs in healthcare facilities, such as the Regional Antibiogram Project.
Additional information about antimicrobial stewardship and why it is critically important can be found at the CDC's Get Smart Campaign.
The HAI Program collects data about HAIs using the National Healthcare Safety Network (NHSN). Data are monitored for infection trends, and to help guide prioritization of projects to reduce HAIs.
The HAI Program provides many educational opportunities, independently and in partnership with other organizations. We partner with APIC Midnight Sun Chapter to provide education for infection preventionists. We host regular webinars on infection prevention topics through the State Contact Nursing Hour Provider Unit. The HAI Program staff are also always available to healthcare providers and the public to answer questions about infection prevention and to address concerns about healthcare-associated infections.
The HAI Program typically does one large, in-person education event each year. Some years we support an Infection Prevention Conference, and some years an Infection Prevention Boot Camp. This 2-day class is designed to make sure there are affordable, in-state options for new or part-time infection prevention staff to learn key concepts of infection prevention. Contact the HAI Program for more information!
What Alaska-specific HAI data are available?
The CDC produces Prevention Status Reports that draw on NHSN data.
What Alaska-specific data about antibiotic resistance are available?
The Regional Antibiogram Project is the most recent data available. There is an Epidemiology Bulletin explaining the project and selected results. The actual antibiograms can also be downloaded.
Certain multi-drug resistant organisms are conditions reportable by state regulations (7 AAC 27.005 and .007) by healthcare providers and laboratories to the Alaska Section of Epidemiology (see below.) Carbapenem-resistant Enterobacteriaceae (CRE) are uncommon in Alaska, but cases do regularly occur. There have been no reported cases of vancomycin-resistant Staphylococcus aureus (VRSA) in Alaska. Additional information about CRE surveillance is available in an Epidemiology Bulletin.
What are HAI and antibiotic resistance reporting requirements in Alaska?
There are several state regulations that address reporting requirements for HAI and antibiotic resistant infections. HAIs tracked through NHSN are not directly reportable to the Section of Epidemiology. However, 7 AAC 27.019 grants us access to all CMS-mandated NHSN reported data. Healthcare facilities who are meeting their CMS NHSN requirements and have granted data viewing rights to the HAI Program have met their requirements for Alaska.
Additionally, infections with antibiotic-resistant organisms "of national importance" must be reported by healthcare providers and laboratories according to state regulations (7 AAC 27.005 and .007). Carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Staphylococcus aureus (VRSA) are specifically mentioned; otherwise, unusual resistance phenotypes as determined by lab microbiologists are encouraged to be reported. It is not necessary to report MRSA infections or Clostridium difficile infections to the Section of Epidemiology (outside of NHSN).
Regardless of the pathogen, clusters or outbreaks are reportable to the state as well. We can provide assistance in investigating and controlling an outbreak.
To report a case of a drug-resistant organism, use the standard reportable disease process. Please send a lab report showing the antimicrobial susceptibility testing results along with the report. More information about reporting to the Section of Epidemiology can be found in the Conditions Reportable Manual.
Our CRE case definition can be found at this link: CRE case definition. CRE is becoming nationally reportable, and Alaska's definition is more broad than the national one.
Resources for Patients:
The CDC and the Association for Professionals in Infection Control (APIC) have many resources to help patients protect themselves against HAIs.
Information from the CDC on Antibiotic Resistance
For those in the community looking for infection control policies, we have a guide for Homeless Shelter Infection Control Recommendations.
Resources for Healthcare Providers:
Feel free to contact the HAI Program (contact information below) if you have a specific issue or questions about infection prevention situations. In addition, we recommend the following sites:
Anna Frick, MPH
Rebecca Hamel, RN, MHI, CIC (she/her)