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August 13 -- The Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS), invites public comments by October 12, 2021 regarding the 2023 Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in U.S. Acute Care Hospitals. This project examines the numbers and types of Healthcare-Associated Infections and causative pathogens, types of antimicrobial drugs (such as antibiotics) used, and the quality of antimicrobial prescribing in U.S. acute care hospitals.
 
Preventing healthcare-associated infections (HAIs) and improving antimicrobial use (AU) are both CDC and national priorities. An essential step in reducing the occurrence of HAIs is to accurately estimate the burden of these infections in U.S. acute care hospitals and to describe the types of HAIs and causative pathogens. Periodic assessments of the magnitude and types of HAIs and AU occurring in all patient populations within acute care hospitals are needed to inform decisions by policy makers and hospital infection control personnel (ICP) regarding appropriate targets and strategies for HAI prevention and antimicrobial stewardship.

Since 2009, CDC has conducted four prevalence surveys (i.e., pilot survey in 2009, limited-scale survey in 2010, and two full-scale surveys in 2011 and 2015) in partnership with the CDC's Emerging Infections Program (EIP) sites. Findings from the most recent survey showed a reduction in the percentage of patients with healthcare-associated infections compared with 2011. CDC was granted approval from OMB to conduct a fifth survey in 2020, but due to the COVID-19 pandemic the survey was postponed to 2023.

Minor adjustments to data collection instruments since the previous 2019 OMB approval have been made. These adjustments were made to enhance future analyses and utility of the survey data. These changes are non-substantive and are not expected to increase the public reporting burden. An extension of the prevalence survey's existing OMB approval is sought to allow a repeat HAI and AU Prevalence Survey to be performed in 2023. A repeat survey will allow assessment of changes in HAI and AU prevalence, pathogen distribution, and quality of antimicrobial prescribing. These data will also allow CDC and its partners to continue to monitor HAI and AU trends, to measure progress in meeting national targets, and to further refine prevention strategies. In the 2023 survey, data collection will occur within acute care general hospitals of varying size in each of the 10 EIP sites (i.e., CA, CO, CT, GA, MD, MN, NM, NY, OR, & TN).

Infection Control Personnel (ICP) in participating hospitals may assist EIP site personnel in collecting demographic and limited clinical data from the electronic or paper-based medical records of a sample of randomly selected patients on a single day in 2023. Patients will not be interviewed, and no direct interaction with patients will occur. Hospital and patient-level data will be collected using unique identification codes. EIP site personnel will submit hospital and patient-level data to CDC using a secure data management system.

Based on experiences from previous surveys, the time required to complete the Healthcare Facility Assessment Form (HFA) and Patient Information Form (PIF) is estimated to be 45 and 17 minutes, respectively. To conduct the full-scale survey in a three-year approval period, 100 hospital respondents will complete both the HFA (1x) and the PIF (on average 63x) per year.

To assess changes in HAIs and AU over time, EIP sites will seek participation from the same hospitals that participated in prior surveys. These hospitals were originally selected for participation using a stratified random sampling scheme based on the number of staffed acute care beds (i.e., small: <150 staffed beds; medium: 151-399 staffed beds; large: >400 staffed beds). Each site will also have the option to recruit additional hospitals for a total of up to 30 in each site. As in previous surveys, hospital participation will remain voluntary. Within each participating hospital, EIP site personnel will establish patient sample size targets based on the number of staffed acute care beds (e.g., up to 75 patients in small hospitals, 75 patients in medium hospitals, and 100 patients in large hospitals).
 
CDC HAI and Antibiotic Use Prevalence Survey webpage: https://www.cdc.gov/hai/eip/antibiotic-use.html
Draft 2023 HAI and Antibiotic Use Prevalence Survey instruments and technical documentation: https://www.dropbox.com/sh/9qkgkf7fvlswv9o/AABKJSVL-7-ZH8G812RGZ91oa?dl=0
FR notice inviting public comment: https://www.federalregister.gov/documents/2021/08/13/2021-17353/proposed-data-collection-submitted-for-public-comment-and-recommendations
 
Point of contact: Nora Chea, Medical Epidemiologist, CDC xdc7@cdc.gov

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