These dashboards show data for healthcare-onset Clostridioides difficile infections (CDI) in Washington state, which is a Washington state reportable healthcare-associated infection (HAI). Hospitals report cases of CDI to the Washington State Department of Health (DOH).
The data for these dashboards comes from the National Healthcare Safety Network (NHSN). This dashboard displays annual data reported during the years 2015-2019.
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What is LabID Event Reporting?
Hospitals self-report their healthcare-associated infections (HAI) and Laboratory Identification (LabID) event data to the CDC and DOH through the CDC's NHSN, which is a secure, web-based surveillance system used by healthcare facilities across the United States. The CDC and the Washington State HAI Program provide training to hospital staff on Clostridioides difficile infection (CDI) case detection and tracking using CDC's CDI surveillance guidelines. More information about NHSN.
CDI LabID events have been reportable to DOH through NHSN since August 2014. Acute Care Hospitals (ACH), Critical Access Hospitals (CAH), Inpatient Rehabilitation Facilities (IRF) and Long-term Acute Care Hospitals (LTAC) are required to report positive laboratory test results from facility-wide (FacWideIN) inpatient locations and emergency departments. FacWideIN does not include behavioral units or inpatient rehabilitation units. It is important to note that these events are denoted as LabID events rather than infections because laboratory tests can detect C. difficile due to colonization or infection.
What is C. Difficile?
Clostridioides (formerly known as Clostridium) difficile (C. difficile) is a type of bacteria that can cause severe diarrhea and can be deadly. This bacteria can also be found in the gut of healthy individuals and animals, and not cause disease; this status would be classified as colonization. Diarrhea associated with this organism can be triggered by antibiotic use. Antibiotic use can disrupt the normal intestinal flora allowing the opportunistic bacteria to cause disease.
C. difficile infections usually occur in people who have recently taken antibiotics and received medical care. Moderate to severe cases can require lengthy hospitalizations, treatment and surgery. C. difficile poses an infection prevention challenge in healthcare settings since the spore forming bacteria can persist in the environment and resist some methods of cleaning and disinfection.
In a study* published in 2015, Centers for Disease Control and Prevention (CDC) estimated that C. difficile caused approximately 500,000 infections and 15,000 deaths each year in the United States. Nearly two-thirds of the estimated C. difficile infections in this study were healthcare associated and 82 percent of all cases reported recent healthcare contact.
What is SIR?
The Standardized Infection Ration(SIR) compares the number of infections in a facility or state to the number of infections that were "predicted," or would be expected, to have occurred based on previous years of reported data (i.e. baseline data). The number of predicted infections is an estimate based on aggregated data reported to CDC's NHSN in 2015 ("baseline period"). The SIR adjusts for differences between healthcare facilities including types of patients and procedures, facility size, medical school affiliation, and type of laboratory test. Risk adjustment factors for each hospital type (acute care, critical access, long-term acute care and inpatient rehabilitation facilities) are detailed in the NHSN Standardized Infection Ration (SIR) Guide to the SIR documentation.
For formula information for SIR and other data information, see technical notes.
*Lessa, Fernanda C, et al. "Burden of Clostridium difficile Infection in the United States." New England Journal of Medicine (2015): 825-834