Hospital-acquired conditions (HACs), or nosocomial infections, affect millions of patients and add billions to global healthcare costs each year.

5 Most Common & Costly HACs1,3

1. Catheter-Associated Urinary Tract Infections (CAUTIs)

CAUTI facts:

  • More than 30% of HACs are urinary tract infections—almost all of these are CAUTIs4
  • Number 1 cause of secondary nosocomial bloodstream infections4
  • Associated with increased morbidity and mortality, prolonged length of stay, and higher hospital costs4
  • $390M – $450M: estimated annual cost to U.S. healthcare system5
  • Responsible pathogens: Escherichia coli (21.4%), Candida spp (21.0%), Enterococcus spp (14.9%), Pseudomonas aeruginosa (10.0%), Klebsiella pneumoniae (7.7%), and Enterobacter spp (4.1%).4

2. Central Line–Associated Bloodstream Infections (CLABSIs)

CLABSI facts:

  • HAC with one of the highest mortality and morbidity rates2
  • Responsible for 1/3 of all HAC deaths6
  • Associated with prolonged length of stay and higher hospital costs7
  • $590M – $2.68B: estimated annual cost to U.S. healthcare system5
  • Responsible pathogens: gram-positive organisms (coagulase-negative staphylococci 34.1%, enterococci 16%, Staphylococcus aureus 9.9%); gram-negatives (Klebsiella 5.8%, Enterobacter 3.9%, Pseudomonas 3.1%, Escherichia coli 2.7%, Acinetobacter 2.2%); Candida species (11.8%); and others (10.5%)7

3. Ventilator-Associated Pneumonia (VAP)

VAP facts:

  • HAC with the highest mortality rate in critically ill patients8
  • Associated with longer mechanical ventilation and prolonged stay in ICU9
  • $780M – 1.5B: estimated annual cost to U.S. healthcare system5
  • Responsible pathogens: aerobic Enterobacteriaceae (25%), Staphylococcus aureus (20%), Pseudomonas aeruginosa (20%), Haemophilus influenza (10%), and streptococci8

4. Surgical Site Infections (SSIs)

SSI facts:

  • Leading cause of hospital readmission following surgery10
  • Associated with increased morbidity and mortality, prolonged length of stay, and higher hospital costs11
  • Most costly to U.S. healthcare system, estimated at $3.5B – 10B annually12
  • Responsible pathogens: Staphylococcus, Streptococcus, Pseudomonas13

5. Clostridium difficile (C. diff)

C. diff facts:

  • Most common microbial cause of HACs14
  • Leading cause of gastroenteritis-associated death in the U.S.15
  • Patients taking antibiotics are at highest risk14
  • $1.0B – $1.62B: estimated annual cost to U.S. healthcare system5

The Role of Biofilms in HACs

Biofilms are colonies of microorganisms that grow on living surfaces as well as non-living surfaces like medical devices.16 Responsible for an estimated 50% of all nosocomial infections,17 biofilms are particularly dangerous because they’ve demonstrated both immune system resistance and antimicrobial resistance.17,18

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  1. CDC website. CDC at Work: preventing healthcare-associated infections. Accessed December 6, 2018.
  2. Infection Control Today website. Device-associated infections: evidence-based practice remains the best way to decrease HAIs. Accessed December 6, 2018.
  3. Zimlichman E, Henderson D, Tamir O, et al. Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039–2046.
  4. CDC website. Guideline for prevention of catheter-associated urinary tract infections 2009. Accessed December 6, 2018.
  5. CDC website. The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Accessed December 6, 2018.
  6. Joint Commission website. Do no harm: prevent central line-associated bloodstream infections. Accessed December 6, 2018.
  7. Haddadin Y, Regunath H. Central line associated blood stream infections (CLABSI) [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan. Accessed December 6, 2018.
  8. Timsit JF, Esaied W, Neuville M, et al. Update on ventilator-associated pneumonia. F1000Res. 2017;6:2061. Published 2017 Nov 29. doi:10.12688/f1000research.12222.1.
  9. CDC website. Ventilator-associated event. Accessed December 6, 2018.
  10. Patient Safety Network website. U.S. Department of Health and Human Services. Surgical site infections. Accessed December 6, 2018.
  11. CDC website. Surgical site infection (SS) event. Accessed December 6, 2018.
  12. ScienceDaily website. Surgical site infections are the most common and costly of hospital infections. Accessed December 6, 2018.
  13. John Hopkins Medicine website. Surgical site infections. Accessed December 6, 2018.
  14. CDC website. Nearly half a million Americans suffered from Clostridium difficile infections in a single year. Accessed December 6, 2018.
  15. Infectious Disease Advisor website. Clostridium difficile in the hospital: infection prevention considerations. Accessed December 6, 2018.
  16. Jamal M, Ahmad W, Andleeb S, et al. Bacterial biofilm and associated infections. J Chin Med Assoc. 2018;81(1):7-11.
  17. Philippe HB, Yves FD. Force matters in hospital-acquired infections. Science. 2018;359(6383):1464-1465.
  18. Infection Control Today website: Biofilms & catheters: the mechanisms of infection. Accessed December 6, 2018.