Healthcare-Associated Infection Facts

Definition

Healthcare-associated infections, or “nosocomial” and “hospital” infections, affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission. They also include infections acquired by patients in the hospital or facility but appear after discharge, and occupational infections among staff.

Third leading cause of death

HAIs are the third leading cause of death in the United States, behind heart disease and cancer. The Center for Disease Control (CDC) estimates:

  • 1.7 million HAIs in hospitals every year
  • 1 out of 25 patients will become infected
  • 90,000 deaths per year

Statistics show we can decrease HAIs

Acute care hospitals report the following infections:

  • Central line-associated bloodstream infections (CLABSI)
  • Catheter-associated urinary tract infections (CAUTI)
  • Select surgical site infections (SSI)
  • Hospital-onset Clostridium difficile infections (C.difficile) and hospital-onset methicillin-resistant staphylococcus aureus (MRSA) bacteremia (bloodstream infections)

A 2013 statistic published on the CDC website shows a reduction in all reported categories but one:

  • A 46 percent decrease in CLABSI between 2008 and 2013
  • A 19 percent decrease in SSIs related to the 10 select procedures tracked in the report between 2008 and 2013
  • A 6 percent increase in CAUTI between 2009 and 2013; although initial data from 2014 seem to indicate that these infections have started to decrease
  • An 8 percent decrease in hospital-onset MRSA bacteremia between 2011 and 2013
  • A 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013

Not all HAIs are reported to the National Healthcare Safety Network (NHSN).

Hospitals are losing revenue from HAIs

  • Medicare does not reimburse for preventable infections — hospitals and insurance companies hold responsibility.
  • Beginning in 2015, hospitals with highest infection rates penalized one percent of Medicare payments. For some hospitals this could be up to 40% of overall revenue.

HAIs spread many ways

Through the air, water and especially surfaces. 

An estimated 20 to 40% of HAIs have been attributed to cross-infection via the hands of health care personnel who have become contaminated from direct contact with patients, or indirectly, by touching contaminated healthcare surfaces. (Source: Understanding and Preventing Transmission of Healthcare-Associated Pathogens Due to Contaminated Hospital Environment David J. Weber, MD, MPH and William A. Rutala, PhD, MPH)

Why proper disinfection is not always happening

Admission to a room previously occupied by a patient with MRSA, VRE, Acinetobacter, or C. difficile increases the risk for the subsequent patient admitted to the room to acquire the pathogen. Improved cleaning and disinfection of room surfaces decreases the risk of healthcare-associated infections. What is critical here is that the surfaces actually be cleanable. There are many different surface materials and textiles within the healthcare environment. They can not all be cleaned the same way. In some cases the surface actually acts as a microbial reservoir as some pathogens are capable of attaching themselves to the surface and are out of reach of the disinfection products.