What is the frequency of healthcare-associated infections (HAIs)?

From the Guidelines

The frequency of healthcare-associated infections (HAIs) is a significant concern in medical settings, with a substantial burden on patient morbidity, mortality, and quality of life. The most recent and highest quality study, 1, highlights the alarming rate of HAIs, which result in significant patient illnesses and deaths, prolong hospital stays, and generate supplementary costs.

Key Points

• HAIs are considered adverse events and are an indicator of the quality of patient care and a patient safety issue 1.
• The true global burden of HAIs remains unknown due to the difficulty in gathering reliable data, but it is estimated that approximately 1 in 31 hospitalized patients develop at least one HAI on any given day.
• Common types of HAIs include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and ventilator-associated pneumonia.
• Patient-specific risk factors that increase HAI likelihood include advanced age, immunosuppression, prolonged hospital stays, invasive procedures, and comorbidities like diabetes.
• To reduce HAIs, healthcare facilities should implement comprehensive infection prevention programs, including proper hand hygiene protocols, appropriate use of personal protective equipment, environmental cleaning, antimicrobial stewardship, and device management protocols 1.
• Regular surveillance is essential to track infection rates and identify problem areas.
• The economic burden of HAIs is substantial, with increased healthcare costs, extended hospital stays, and higher mortality rates.
• Preventing HAIs requires a multidisciplinary approach involving healthcare workers at all levels, from frontline staff to administration, working together to implement evidence-based prevention strategies.

Prevention Strategies

• Implementing multifaceted interventions can reduce HAI rates by 35-55% 1.
• Using devices and equipment, such as plastic adhesive skin barriers, high flow oxygen supplementation, and wound protection, can help prevent surgical site infections 1.
• Simple strategies, such as skin cleansing protocols, hair removal, and maintenance of intraoperative normothermia, can also be effective in preventing HAIs 1.

From the Research

Frequency of Healthcare-Associated Infections (HAIs)

• The frequency of HAIs is a significant concern, with studies indicating that they are the most common adverse event in hospitals and a major public health problem 2.
• According to a study published in 2020, the frequency of HAIs increased from 8.6% to 16.9% over a period of 5 years after the implementation of an antibiotic stewardship and infection control program 3.
• Another study published in 2012 found that at least 1 pathogen was isolated from 83.5% of 33,797 HAIs, with Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus species, and Clostridium difficile being the most common pathogens 4.
• The relative frequency of HAIs by infection site has been found to vary over time, with significant increases in certain pathogens such as S aureus, CoNS, and Enterococcus in different infection sites 4.

Factors Affecting HAI Frequency

• The implementation of infection control programs, such as hand hygiene campaigns and antibiotic stewardship programs, can significantly reduce the frequency of HAIs 5, 3.
• However, sustaining these interventions can be challenging, and continuous input, ongoing surveillance, and long-term monitoring are necessary to maintain compliance and effectiveness 3.
• The use of Infection Control Link Nurses (ICLNs) has been found to be a useful strategy in reducing HAIs, with studies indicating that ICLNs can play a key role in preventing and controlling HAIs 6, 2.