The number of patients receiving medical care in the home has risen dramatically during the last decade, putting patients increasingly at risk of acquiring an infection while convalescing in the home, according to research presented by scientists with the Centers for Disease Control and Prevention during the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections in Atlanta, Georgia.

CDC is striving to further address infections associated with home health care. "We need to extend to home health care delivery the same standards we have applied to the hospital setting," said Julie Gerberding, M.D., CDC's director of its Hospital Infections Program (HIP). "We have to monitor the frequency of these events and learn how to prevent them."

An estimated 8 million Americans received medical care in the home in 1996, the latest year for which data are available according to Michele Pearson, M.D., a medical epidemiologist in CDC's HIP. In 1996, there were an estimated 11,409 home care agencies and 7.8 million discharges, representing 69 percent and 150 percent increases respectively since 1992. "Significantly, in 1996, 10 percent of home care patients had an invasive medical device, typically used in hospital settings, such as ventilators, urinary catheters, and vascular catheters. I think it is safe to say that those numbers will continue to increase as health care delivery in the United States continues to change."

Lilia Manangan, an epidemiologist in HIP, presented data on the prevalence of infections among patients in home care. Manangan, in collaboration with the Missouri Alliance for Home Care — a non-profit association that provides home care education, advocacy, and information for its members — reports that 16 percent of 5,148 patients that were monitored during one month in 1999 in Missouri home care agencies had infections.

"People who receive medical care in the home are at risk of acquiring the same infections as those in hospitals like urinary tract infections, respiratory tract infections, surgical site infections, and bloodstream infections," Manangan said. "As is the case with infections acquired in hospitals, the use of medical devices like urinary and central venous catheters in the home appears to increase one's risk of acquiring an infection." Manangan suggested that health care providers enhance efforts to prevent infections in the home.

Combating infections associated with home health care is one of many issues addressed in CDC's plan "Addressing Emerging Infectious Diseases: A Strategy for the 21st Century." For more information about this plan please visit http://www.cdc.gov/ncidod/emergplan/index.htm.