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Can You Answer These 6 Questions About Healthcare-Acquired Infections (HAIs)?

November 15, 2021

It may seem odd to learn that someone can get an infection while in the hospital or other healthcare facility, but it’s true. One of every 31 people who spend time in a hospital will get a healthcare-acquired infection (HAI), also called a nosocomial infection. The COVID-19 pandemic could be part of the HAI increase, as hospitals redirect resources. Knowing about HAIs can help you protect yourself and your loved ones. How much do you know about HAIs?

1- What causes HAIs?

Although infections can be bacterial, viral, fungal, or parasitic, HAIs are most often caused by bacteria. There are many, but among the most common are streptococcus and staphylococcus infections, as well as those caused by E. coli. Former President Bill Clinton’s recent UTI, which led to a hospital stay, was caused by E. coli bacteria, although in Clinton’s case, it was not an HAI.

2- What are the most common HAIs?

One of the reasons patients are at risk for infections while in the hospital is because they often have invasive devices, such as intravenous (IV) lines and urinary catheters. Surgery introduces an unnatural opening in the skin, and very sick patients might need a ventilator to help them breathe. These can lead to:

  • Catheter-associated urinary tract infection (CAUTI)
  • Central line-associated bloodstream infection (CLABSI)
  • Surgical site infection (SSI)
  • Ventilator-associated events (VAE)

According to the National Healthcare Safety Network, the most common infections related to healthcare facilities, are urinary tract infections; soft tissue infections, such as in muscle and fat; gastroenteritis; meningitis; and respiratory infections, like pneumonia.

Another common HAI is caused by Clostridioides difficile, often called C. difficile or C. diff. It is often the result of prolonged antibiotic use. The bacteria spread easily from person to person in the facilities. It also spreads through contact when with bacteria left behind on hard surfaces, such as bedside tables and door handles.

3- If I am hospitalized with an infection, is that an HAI?

No, if you have an infection when admitted to a hospital, this is a community-acquired infection. Only infections that begin in a healthcare facility are HAIs. It is possible that you don’t know you have an infection when you go to the hospital. The signs may only show once you are in the hospital. But this is still not an HAI.

4- What are some other risks for contracting an HAI?

Aside from having an invasive device or surgery, the basic risk factors for getting an infection while in a healthcare facility are much the same as out in the public. People at risk include those who are very old or very young, as well as those who have an impaired immune system.

Other risks include people who:

  • Are malnourished
  • Drink alcohol excessively
  • Smoke heavily
  • Have chronic lung disease
  • Have diabetes
  • Stay in bed or immobile for extended periods

5- Why are HAIs dangerous?

People who are otherwise healthy who get infections can usually fight them with their immune system and, when needed, antimicrobials like antibiotics or antivirals. But if someone is already sick or injured, as hospital patients and long-term care patients are, infections can make them sicker and more likely to have more complications.

In addition, many of the infections in healthcare facilities are caused by so-called superbugs. These are microbes that are antimicrobial resistant. For example, C. diff is a superbug, as is MRSA (methicillin-resistant staphylococcus aureus). They are antibiotic resistant.

According to the Centers for Disease Control and Prevention (CDC), each year, more than 2 million people in the United States die as the result of drug-resistant bacteria.

6- How can I protect myself from an HAI?

It can be harder to protect yourself from infections while in the hospital than at home. You have less control over your environment. That being said, there are some steps you can take to lower your risk of contracting an infection while you are in a hospital or healthcare facility.

  • Ensure that everyone who comes into your room, from visitors to hospital staff, wash their hands before approaching you.
  • Wash your own hands frequently.
  • Use your own antiseptic wipes to wipe down your table, side rails, phone, and anything else within reach.
  • Allow housekeeping staff to come in and clean, even if it is not convenient. They may not be able to return later.
  • Tell friends and family who are ill to not come visit.
  • If you have an invasive device, like a urinary catheter, ask when it should come out. Ask each day if there is no set time. While these devices are important, they should not remain in place longer than necessary.
  • Report any diarrhea to your nurse, especially if you are taking antibiotics.

If you show signs of any new illnesses, other than what brought you to the hospital, report it right away. Some symptoms for common HAIs include, but are not limited to:

  •             Fever and chills
  •             Burning on urination
  •             Need to urinate frequently, urgently
  •             Cloudy and/or foul-smelling urine
  •             Coughing
  •             Bringing up sputum that is yellow, green or pink/red
  •             Increasing pain around a wound
  •             Pus or discharge from a wound

If you have any kind of infection, whether you are in the hospital or not, it is vital to watch for signs of sepsis. Sepsis is a medical emergency.


Are you are a healthcare professional? Check out Sepsis Alliance’s second Healthcare-Associate Infection (HAI) Mini-Summit.  The HAI Mini-Summit is virtual and free for healthcare providers across the continuum of care. To learn more and register for the activity, please visit Programming updates, including a finalized agenda, will be posted on the website as they become available.