I 
110TH CONGRESS 
1ST SESSION H. R. 4214 
To improve the prevention, detection, and treatment of community and 
healthcare-associated infections (CHAI), with a focus on antibiotic-resist-
ant bacteria. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 15, 2007 
Mr. CUMMINGS (for himself, Mr. SARBANES, Mr. TOWNS, and Mr. WYNN) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To improve the prevention, detection, and treatment of com-
munity and healthcare-associated infections (CHAI), with 
a focus on antibiotic-resistant bacteria. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Community and 
Healthcare-Associated Infections Reduction Act of 2007’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Effective antibiotics have transformed the 
practice of medicine and saved millions of lives, but 
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the emergence and spread of antibiotic-resistant bac-
terial pathogens poses a significant threat to patient 
and public health. 
(2) Although many antibiotic-resistant infec-
tions occur most frequently among individuals in 
hospitals and other healthcare facilities, they also af-
fect otherwise healthy individuals in the community. 
(3) According to the Centers for Disease Con-
trol and Prevention (referred to in this Act as the 
‘‘CDC’’), healthcare-associated infections (referred 
to in this Act as ‘‘HAI’’) are one of the top 10 lead-
ing causes of death in the United States. 
(4) In American hospitals alone, HAI account 
for an estimated 1,700,000 infections and 99,000 
associated deaths each year. In 70 percent of these 
deaths, the bacteria are resistant to at least one 
commonly used antibiotic. 
(5) Dr. John Jernigan, Chief of Interventions 
and Evaluations at the CDC, estimates that HAI in 
hospitals result in up to $27,500,000,000 in addi-
tional healthcare costs annually. The growing prob-
lem of antibiotic resistance, which affects the most 
common and least expensive antibiotics first, also 
shifts utilization toward more expensive antibiotics. 
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(6) Methicillin-resistant Staphylococcus aureus 
(referred to in this Act as ‘‘MRSA’’), one of the 
most dangerous forms of antibiotic-resistant staph 
infections, highlights the magnitude of the problem. 
A recent study by the CDC estimates that nearly 
95,000 people became infected with invasive MRSA 
in 2005 in the United States, resulting in 19,000 
deaths, more than the number who died from HIV/ 
AIDS, Parkinson’s disease, emphysema, or homicide. 
A vast majority (85 percent) of these infections were 
associated with healthcare treatment. 
(7) MRSA also affects individuals outside the 
healthcare setting and in the community. Recent 
weeks have seen an increase by health and education 
officials in reported staph infection outbreaks, in-
cluding antibiotic-resistant strains. These infections 
have occurred in New York, Kentucky, Virginia, 
Maryland, Illinois, Ohio, North Carolina, Florida, 
and the District of Columbia. 
(8) The problem of antibiotic-resistant infec-
tions is not limited to MRSA. High levels of resist-
ance 
in 
enterococci, 
Klebsiella 
pneumonia, 
Pseudomonas aeruginosa, and E. coli have also been 
reported. 
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(9) Antibiotic-resistant infections have been dis-
covered in troops coming back from Iraq and Af-
ghanistan. A CDC study showed that between 
March and October 2003, 145 United States service 
members at military treatment facilities were in-
fected or colonized with a multidrug-resistant gram- 
negative bacterium called Acinetobacter baumannii. 
The most likely source of this outbreak was bacteria 
within deployed field hospitals. 
(10) Despite this significant public health 
threat, information on community and healthcare-as-
sociated infections (referred to in this Act as 
‘‘CHAI’’) is incomplete and unreliable. Policy-
makers, healthcare providers, and individual con-
sumers have little information about hospital infec-
tion rates, making it difficult to diagnose the scope 
of the problem and evaluate current infection pre-
vention efforts, and assess potential remedies. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of the Centers for 
Medicare & Medicaid Services. 
(2) AHRQ.—The term ‘‘AHRQ’’ means the 
Agency for Healthcare Research and Quality. 
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(3) CHAI.—The term ‘‘CHAI’’ means commu-
nity and healthcare-associated infections. 
(4) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention, unless otherwise specifically designated. 
(5) HAI.—The term ‘‘HAI’’ means healthcare- 
associated infections, which are infections that pa-
tients acquire during the course of receiving treat-
ment for other conditions within a healthcare set-
ting. 
(6) HOSPITAL.—The term ‘‘hospital’’ means a 
subsection (d) hospital (as defined in section 
1886(d)(1)(B) of the Social Security Act (42 U.S.C. 
1395ww(d)(1)(B))). 
(7) INTERAGENCY WORKING GROUP.—The term 
‘‘interagency working group’’ means the interagency 
working group on community and healthcare-associ-
ated infections established under section 9. 
(8) 
MRSA.—The 
term 
‘‘MRSA’’ 
means 
Methicillin-resistant Staphylococcus aureus. 
(9) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
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SEC. 4. COMMUNITY AND HEALTHCARE-ASSOCIATED IN-
FECTION CONTROL PROGRAM. 
(a) ESTABLISHMENT OF BEST PRACTICES GUIDE-
LINES FOR INFECTION CONTROL.— 
(1) IN GENERAL.—Not later than 90 days after 
the date of enactment of this Act, AHRQ in collabo-
ration with CDC shall develop best-practices guide-
lines for internal infection control plans to prevent, 
detect, control, and treat CHAI at hospitals. 
(2) REQUIREMENTS.—In carrying out para-
graph (1), AHRQ shall— 
(A) establish a set of best practices with 
supporting justification of their appropriateness 
and effectiveness based on nationally-recognized 
or evidence-based standards, which practices 
may include— 
(i) the establishment of an infection 
control oversight committee; and 
(ii) the establishment of measures for 
the prevention, detection, control, and 
treatment of CHAI, such as— 
(I) staff training and education 
on CHAI prevention and control, in-
cluding the monitoring and strict en-
forcement of hand hygiene procedures; 
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(II) a system to identify, des-
ignate, and manage patients known to 
be colonized or infected with CHAI, 
including diagnostic surveillance proc-
esses and policies, procedures and 
protocols for staff who may have had 
potential exposure to a patient or resi-
dent known to be colonized or infected 
with a CHAI, and an outreach process 
for notifying a receiving healthcare fa-
cility of any patient known to be colo-
nized or infected with CHAI prior to 
transfer of such patient within or be-
tween facilities; 
(III) the development and imple-
mentation of an infection control 
intervention protocol that may include 
active detection and isolation proce-
dures, the alternation of the physical 
plan of a hospital, the appropriate use 
of anti-microbial agents, and other in-
fection control precautions for general 
surveillance of infected or colonized 
patients; 
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(B) work in collaboration with other agen-
cies and organizations whose area of expertise 
is the identification, treatment, and prevention 
of infectious disease; 
(C) publish proposed guidelines for inter-
nal infection control plans; 
(D) provide for a comment period of not 
less than 90 days; and 
(E) establish final guidelines, taking into 
consideration any comment received under sub-
paragraph (D). 
(b) CONSULTATION
OF BEST PRACTICES GUIDE-
LINES.—The Administrator shall consult best practices 
guidelines in evaluating hospitals infection control plans 
as a condition of participation in the Medicare program. 
(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated such sums as may be necessary for 
each of fiscal years 2008 through 2012. 
SEC. 5. COLLECTION, REPORTING, AND COMPILATION OF 
COMMUNITY AND HEALTHCARE-ASSOCIATED 
INFECTION DATA. 
(a) IN GENERAL.—Not later than 120 days after the 
date of enactment of this Act, hospitals shall report infor-
mation about CHAI to the CDC National Healthcare 
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