Infections prompt U.S. study

Congressional concerns about disease outbreaks in ambulatory surgery centers, including the hepatitis C outbreak at a Las Vegas endoscopy center, have prompted a nationwide study to determine what role the facilities play in the spread of health care-associated infections.

"There have been situations across the country that have raised concerns about the problems in those health care settings,'' said Cynthia Bascetta, director of health care for the federal Government Accountability Office, which is doing the study.

The study, in the planning stage but expected to be complete by February, will determine to what extent data are available on the frequency and characteristics of health care-associated infections in ambulatory surgery centers.

Instead of just looking at how many infections occurred in outpatient surgery centers, the study also will determine whether the facilities are following appropriate infection-control procedures, Bascetta said.

"One of the problems is that people aren't admitted into ambulatory surgery centers, so it is much harder to figure out what the source of an infection is if that person is being treated elsewhere,'' she said.

Data will be collected from the Centers for Disease Control and Prevention, which conducts surveillance of disease outbreaks, and the Centers for Medicare and Medicaid Services, which regulates ambulatory surgery centers and monitors their infection-control policies.

By studying the link between care provided at outpatient clinics and the spread of infectious diseases such as hepatitis C, the hope is to prevent future outbreaks like that experienced in Las Vegas, said Rep. Shelley Berkley, D-Nev.

Berkley and Rep. Jon Porter, R-Nev., were among several House members to call for such a study.

Larry Matheis, executive director of the Nevada State Medical Association, said the hepatitis C outbreak in Las Vegas has led to several health care studies and changes to infection-control policies.

In particular, the Nevada State Health Division has created a committee to look at infection control in all of Nevada's health care settings, including physician offices.

Also, the state's medical association is one of only six in the country involved in a national steering committee for the Safe Injection Practices Education and Awareness Campaign.

The campaign, which will be piloted in Nevada, is a multi-pronged media effort to raise awareness about safe injection practices.

The CDC also plans to release a report in January about the several outbreaks that have occurred because of injection practice problems similar to those found in Las Vegas.

According to a letter by the GAO sent to House members about the study, the CDC estimates that about 1.7 million health care-associated infections occur in hospitals each year, resulting in $4.5 billion in excess health care costs.

An increasing number of medical procedures are being performed in non-hospital settings such as ambulatory surgery centers. The CDC estimates that such facilities provide 6 million procedures per year and often have limited infection-control resources compared with those in hospitals.

"Nevada is not unique, but our high visibility has really given us the opportunity to use the terrible Las Vegas outbreak and to make a serious effort at making any repeat impossible,'' Matheis said.

"I do believe that there will be significant long-range benefits to the nation's health care resulting from the positive response to the Las Vegas outbreak, although the price has been high for patients who should not have been placed at risk and for the lost confidence in the health care system.''

Contact reporter Annette Wells at awells@reviewjournal.com or 702-383-0283.