NACCHO has released its 2024 NACCHO HAI/AR Report, highlighting the efforts of local health departments in leading infection control and prevention (IPC) initiatives. The new report shows how initiatives supported by NACCHO have empowered local health departments to reduce the threat of healthcare-associated infections and antimicrobial resistance (HAI/AR) in their communities, a challenge which affects millions of people globally every year. These efforts have significantly improved the capacity of local health departments and partner healthcare facilities to perform HAI/AR work, build stronger community partnerships, and perform more outbreak response activities across multiple facilities at risk of outbreaks.

According to the Centers for Disease Control and Prevention (CDC), more than 2.8 million antimicrobial-resistant infections occur each year in the United States, further complicating the already challenging work of healthcare providers in treating infections, like HAIs. Many organisms that were once easily treated with antibiotics have developed resistance due to misuse and overuse of antibiotics. The CDC estimates that US doctors’ offices and emergency departments prescribe about 47 million antibiotic courses yearly for infections that do not require antibiotics. This issue was further exacerbated by the widespread impact of COVID-19, which added another layer of complexity to the proper prescription of antibiotics.

Between July 2020 and July 2023, NACCHO launched six project initiatives that enabled local health departments to develop strategic approaches to combat HAI/AR. While each initiative had a unique focus, the report highlights common threads of progress across all participating sites, including:

• Improved Organizational Infrastructure: Key improvements were made in infrastructure and capacity to better respond to HAI/AR threats. Local health departments have hired new staff dedicated to HAI/AR efforts that have improved their capacity to perform IPC activities in several areas, including sharing federal guidance and resources and recommending key measures to prevent or contain outbreaks. Participating sites have also reported higher capacity for developing data systems and procedures for outbreak management.
• Increased Staff Confidence: Participating sites across four projects reported increases in confidence in engaging in IPC and HAI/AR activities, specifically showing a 67% increase in conducting diagnostic testing, environmental cleaning, and cohorting. Participants in one initiative, which ran from January 2022 to June 2023, reported a significant 35% confidence gain overall.
• Stronger Community Partnerships: Local health departments reported improved relationships with multiple community partners, including increased collaborations with state HAI/AR program facilities and long-term/post-acute care facilities. Relationship strength showed improvement across all measures, with significant gains in the areas of shared vision, open and trusted communication, and reliability in facility partners in IPC-related roles.
• Increased Outreach Activities and Support: Through cultivating stronger partnerships, local health departments were able to provide more IPC and HAI/AR support by engaging over 500 facility partners. This helped local health departments reach more facilities and increase activities to prevent and respond to infection outbreaks. Participating local health departments reported significant increases in conducting or supporting infection control assessment and response tools to prevent infection (153% increase), testing or point prevalence surveys (152% increase), and the provision of outbreak response support (124% increase).

Leaders in public health continue to work to mitigate the risk of HAI/AR in high-risk settings across the country, and local health departments serve a key role on the frontlines of this response. Findings from the 2024 NACCHO HAI/AR Report demonstrate how continued federal investment in public health is critical to sustain the life-saving work of HAI/AR prevention and control. Additionally, it highlights the need to support the public health workforce so to ensure they are better prepared to respond to the potential challenges of future public health emergencies.

To view the full report and learn more about the findings, visit: https://www.naccho.org/uploads/downloadable-resources/HAI-AR-Project-Brief.pdf

To learn more about NACCHO’s work in infectious disease prevention and control, visit: https://www.naccho.org/programs/community-health/infectious-disease/infectious-disease-prevention-and-control

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About NACCHO

The National Association of County and City Health Officials (NACCHO) represents the over 3,300 local governmental health departments across the country. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information, visit www.naccho.org.