Healthcare-Associated Infections

Background

Healthcare-associated infections (HAIs) exact a significant toll on human life. They are among the leading causes of preventable death in the United States, accounting for an estimated 1.7 million infections and 99,000 associated deaths in 2002. In hospitals, they are a significant cause of morbidity and mortality. In addition to the substantial human suffering caused by healthcare-associated infections, the financial burden attributable to the infections is staggering. It is estimated that healthcare-associated infections cause $28 to $33 billion in excess healthcare costs each year.

For these reasons, the prevention and reduction of healthcare-associated infections is a top priority for the U.S. Department of Health and Human Services (HHS). The HHS Steering Committee for the Prevention of Healthcare-Associated Infections was established in July 2008. The Steering Committee was charged with developing a comprehensive strategy to prevent and reduce healthcare-associated infections and issuing a plan which establishes national goals for healthcare-associated infection prevention and outlines key actions for achieving identified short- and long-term objectives. The plan is also intended to enhance collaboration with external stakeholders to strengthen coordination and impact of national efforts.

What are Healthcare-Associated Infections?

Healthcare-associated infections are infections that patients acquire while receiving treatment for medical or surgical conditions. HAIs occur in all settings of care, including acute care within hospitals and same day surgical centers, ambulatory outpatient care in healthcare clinics, and in long-term care facilities, such as nursing homes and rehabilitation facilities. HAIs are associated with a variety of causes, including (but not limited to) the use of medical devices, such as catheters and ventilators, complications following a surgical procedure, transmission between patients and healthcare workers, or the result of antibiotic overuse.

Four categories of infections account for approximately three quarters of HAIs in the acute care hospital setting:

Surgical site infections;
Central line-associated bloodstream infections;
Ventilator-associated pneumonia, and;
Catheter-associated urinary tract infections.

In addition, infections associated with Clostridium difficile and Methicillin-resistant Staphylococcus aureus (MRSA) also contribute significantly to the overall problem. The frequency of HAIs varies by location. Currently, urinary tract infections comprise the highest percentage (34%) of HAIs followed by surgical site infections (17%), bloodstream infections (14%), and pneumonia (13%). In addition to the substantial human suffering exacted by HAIs the financial burden attributable to these infections is staggering. It is estimated that HAIs incur an estimated $28 to $33 billion in excess healthcare costs each year.