What is the cause of hospital-acquired infections?
Hospital-acquired infections (HAIs) are often caused by bacteria and other pathogens that are prevalent in a healthcare environment. When a patient is ill or injured, they may have a compromised immune system that is not successful in fighting off these infections when they are exposed to them. A patient may develop an infection in hospitals that are not as clean as they should be, or when the medical staff fails to follow best practices in preventing HAIs.
Common types of hospital-acquired infections
Some of the most common types of HAIs include the following:
- Central line-associated bloodstream infection (CLABSI)
- Methicillin-resistant Staphylococcus Aureus (MRSA)
- Catheter-associated urinary tract infections (CAUTI)
- Surgical site infections
- Clostridium difficile
- Ventilator-associated Pneumonia (VAP)
- Surgical site infection (SSI)
The CDC conducts an annual National and State Healthcare-Associated Infections Progress Report (HAI Progress Report), which provides state and national progress in preventing HAIs. Some of the highlights of the 2014 data include:
- There was a 50 percent decrease in central line-associated bloodstream infections between 2008 and 2014
- There was no change overall in the rate of CAUTIs between 2009 and 2014
- They found a 17 percent decrease in SSIs between 2008 and 2014 for 10 select procedures including abdominal hysterectomy and colon surgery.
In 2014, there were approximately 722,000 HAIs in acute care hospitals in the United States, and 75,000 patients with HAIs died during their hospitalizations.
The CDC tracks HAIs on a state-by-state basis. For 2014, here are a few highlights for Washington, D.C:
Of the 12 reporting hospitals in the District of Columbia, 8 hospitals had a 40 percent lower SIR (standard infection ratio) for CLABSIs than the national SIR, 7 hospitals had a 2 percent higher SIR than the national rate for CAUTIs, and 8 hospitals had a 5 percent lower MRSA SIR vs. the national rate.
The District of Columbia is taking action to prevent these specific HAIs:
- Central line-associated bloodstream infections
- Catheter-associated urinary tract infections
- Multidrug-resistant infections (CRE)
If you contracted a hospital-acquired infection while you were in the hospital, or within three days of being discharged from a hospital stay, you may want to schedule a consultation with an experienced Washington, D.C. medical malpractice attorney from Paulson & Nace, PLLC. Please call 202-463-1999 or fill out our contact form to learn more about our services.
Anyone getting medical care is at some risk for an HAI; however, some people are at higher risk than others, including the following:
Very young people – premature babies and very sick children.
Very old people – the frail and the elderly.
People with certain medical conditions – such as diabetes.
People with weakened immune systems – from disease, or because they are getting trreatments that weaken their immune system. Cancer treatments (like chemotherapy or radiation) or steroids are treatments that can weaken the immune system.
Other risk factors:
Length of stay in a healthcare facility – a long hospital stay.
Surgery – long and complicated surgery.
Hand washing techniques – inadequate hand washing by hospital staff, visitors, and patients.
Antibiotics – overuse of antibiotics can lead to resistant bacteria, which means that antibiotics become less effective and do not work as well.
Equipment – medical equipment that enters the body can introduce bacteria and infection into the body. For example, urinary catheters, intravenous drips and infusions, respiratory equipment, and drain tubes.
Wounds – wounds, incisions (surgical cuts), burns, and skin ulcers are all prone to infection.
High-risk patient care areas – some patient care areas are more likely to have infections, such as hospital intensive care units.
To contact the Healthcare Associated Infections Program, please call 860-509-7995.
1. Horan TC, Gaynes RP. Surveillance of nosocomial infections. In: Mayhall CG, editor. Hospital epidemiology and infection control. Philadelphia: Lippincott Williams and Wilkins; 2004. pp. 1659–702. [Google Scholar]
2. Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr. 2002;140:432–8. [PubMed] [Google Scholar]
3. Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr. 2001;139:821–7. [PubMed] [Google Scholar]
4. Zaoutis TE, Coffin SE. Clinical Syndromes of Device-Associated Infections. In: Long SS, Pickering LK, Prober CG, editors. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia (US): Churchill Livingstone; 2008. p. 102. [Google Scholar]
5. Prabhu N, Sangeetha M, Chinnaswamy P, Joseph PI. A rapid method of evaluating microbial load in health care industry and application of alcohol to reduce nosocomial infection. Journal of the Academy of Hospital Administration. 18(1) (2006-01-2006-12) [Google Scholar]
6. Slaughter S, Hayden MK, Nathan C, Hu TC, Rice T, Van Voorhis J, et al. A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med. 1996;125:448–56. [PubMed] [Google Scholar]
7. Bonten MJ, Hayden MK, Nathan C, Van Voorhis J, Matushek M, Slaughter S, et al. Epidemiology of colonisation of patients and environment with vancomycinresistant enterococci. Lancet. 1996;348:1615–9. [PubMed] [Google Scholar]
8. Fridkin SK, Welbel SF, Weinstein RA. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am. 1997;11:479–96. [PubMed] [Google Scholar]
9. Weinstein RA. Controlling antimicrobial resistance in hospitals: Infection control and use of antibiotics. Emergency Infect. Dis. 2001;7:188–92. [PMC free article] [PubMed] [Google Scholar]
10. Kollef MH, Ward S, Sherman G, Prentice D, Schaiff R, Huey W, et al. Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med. 2000;28:3456–64. [PubMed] [Google Scholar]
11. Mathieu LM, De Muynck AO, Leven MM, De Dvoy JJ, Goossens HJ, Van Reempts PJ. Risk factors for central vascular catheter-associated bloodstream infections among patients in a neonatal intensive care unit. J Hosp Infect. 2001;48:108–16. [PubMed] [Google Scholar]
12. Newman CD. Catheter-related bloodstream infections in the pediatric intensive care unit. Semin Pediatr Infect Dis. 2006;17:20–4. [PubMed] [Google Scholar]
13. Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. The National Epidemiology of Mycosis Survey study group. Pediatr Infect Dis J. 2000;19:319–24. [PubMed] [Google Scholar]
14. Edward AM, Warren DK, Fraser VJ. Ventilator-associated pneumonia in pediatric intensive care unit patients: Risk factors and outcomes. Pediatrics. 2002;109:758–64. [PubMed] [Google Scholar]
15. Apisarnthanarak A, Holzmann-Pazgal G, Hamvas A, Olsen MA, Fraser VJ. Ventilator-associated pneumonia in extremely preterm neonates in a neonatal intensive care unit: Characteristics, risk factors, and outcomes. Pediatrics. 2003;112:1283–9. [PubMed] [Google Scholar]
16. Tikhomirov E. WHO programme for the control of hospital infections. Chemioterapia. 1987;6:148–51. [PubMed] [Google Scholar]
17. Rosenthal VD, Maki DG, Mehta A, Alvarez-Moreno C, Leblebicioglu H, Higuera F. International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008. Am J Infect Control. 2008;36:627–37. [PubMed] [Google Scholar]
18. Gastmeier P, Geffers C, Brandt C, Zuschneid I, Sohr D, Schwab F. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect. 2006;64:16–22. [PubMed] [Google Scholar]
19. Klevens RM, Edwards JR, Richards CL, Jr, Horan TC, Gaynes RP, Pollock DA, et al. Estimating healthcare-associated infections in US hospitals, 2002. Public Health Rep. 2007;122:160–6. [PMC free article] [PubMed] [Google Scholar]
20. Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. CDC. 2008. [Accessed 2009 Jan 7]. Available from: //www.cdc.gov/ncidod/dhqp/pdf/Scott_CostPaper.pdf .
21. Liang SY, Marschall J. Vital signs: Central line-associated blood stream infections-United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep. 2011;60:243–8. [PubMed] [Google Scholar]
22. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1999;103:e39. [PubMed] [Google Scholar]
23. Coffin SE, Zaoutis TE. Healthcare-Associated Infections. In: Long SS, Pickering LK, Prober CG, editors. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia: Churchill Livingstone; 2008. Chapter 101. [Google Scholar]
24. Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr. 2002;140:432–8. [PubMed] [Google Scholar]
25. Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr. 2001;139:821–7. [PubMed] [Google Scholar]
26. Horan TC, Andrus M, Dureck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309–32. [PubMed] [Google Scholar]
27. Scheckler WE, Brimhall D, Buck AS, Farr BM, Friedman C, Garibaldi RA, et al. Requirements for infrastructure and essential activities of infection control and epidemiology in hospitals: A consensus panel report. Infect Control Hosp Epidemiol. 1998;19:114–24. [PubMed] [Google Scholar]
28. Goldmann DA, Weinstein RA, Wenzel RP, Tablan OC, Duma RJ, Gaynes RP, et al. Strategies to prevent and control the emergence and spread of antimicrobialresistant microorganisms in hospitals. A challenge to hospital leadership. JAMA. 1996;275:234–40. [PubMed] [Google Scholar]
29. Tenover FC, Arbeit RD, Goering RV. How to select and interpret molecular strain typing methods for epidemiological studies of bacterial infections: A review for healthcare epidemiologists. Infect Control Hosp Epidemiol. 1997;18:426–39. [PubMed] [Google Scholar]