A healthcare-acquired infection (HAI) is an infection contracted in a healthcare facility, such as an acute care hospital or a skilled nursing care facility. Even a doctor’s office or clinic can be a source for an HAI. The medical community calls HAIs nosocomial infections. Community-acquired infections develop outside a healthcare facility.
As with any type of infection, HAIs can cause sepsis, particularly in people who are already at risk, such as those with chronic illnesses (like diabetes), who are immunocompromised (such as those taking chemotherapy or who don’t have a spleen), the very young (infants), and the very old.
Sometimes incorrectly called blood poisoning, sepsis is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
How do healthcare acquired infections happen?
Anyone can get an infection, but as with certain people in the community, many people in hospital environments have a higher risk of getting an infection because of chronic illness, age, or other risk factors. Hospitals and other healthcare facilities add extra risks:
Concentrated exposure to germs:
Healthcare facilities have other sick people who could spread infections. Patients see more people while they’re in a healthcare facility than they might normally be (workers, volunteers, and visitors, for example). These people could unknowingly transfer germs from patient to patient.
Interventions that cause a break in your skin
or introduce a piece of medical equipment inside your body can cause an infection. The most common interventions that can cause an infection include:
– Central lines (also called central venous catheters) – People who are seriously ill may have a central line, a special type of intravenous (IV) catheter. This allows nurses to effectively provide antibiotics or other medications and fluids.
A doctor inserts the central line into a large vein in your groin, chest or neck. Because these special IVs are in a large vein, they can stay in place for several weeks or longer. This eliminates the need to keep restarting IVs in the more delicate veins in the arm. However, a drawback is that these larger veins give more direct access to the heart, and infections can become very serious very fast.
A central line infection is a central line-associated bloodstream infection, or CLABSI.
– Urinary tract infections – Patients in the hospital and in long-term care facilities may have a urinary catheter – a tube inserted into the urethra, which drains urine from the bladder. Infections resulting from a urinary catheter are catheter-associated UTIs, or CAUTIs. According to statistics, 75% of all UTIs in the hospital are CAUTIs, and they are the most common type of healthcare-acquired infection today.
– Surgical site infection – If you have surgery, your wound is at risk for getting infected. The severity of the infection can range from a superficial infection in the skin around the surgical incision, to a much deeper internal infection. Surgical site infections are SSIs.
– Ventilator-associated pneumonia – When people are on a ventilator because they need help breathing, they are at risk for developing pneumonia, an infection in the lungs. Called ventilator-associated pneumonia, or VAP, there are many possible causes for this type of infection. They include exposing the lungs (from the tube) to bacteria that may not normally be able to reach the lungs.
– Pressure injuries – Patients how are confined to bed or spend extended time in a chair or wheelchair are at risk for developing a pressure injury or sore. Seniors can also have fragile skin that tears easily. These injuries can become infected, as well.
What types of infections are HAIs?
Technically, any type of infection caught in a healthcare facility is an HAI. However, some types of bacteria are more common in these types of places than others. These include, among others:
- Methicillin-resistant Staphylococcus aureus, commonly referred to as MRSA.
- Clostridioides difficile, often called C. difficile or C. diff. This infection used to be called Clostridium difficile.
- Vancomycin-resistant Enterococcus.
Treating HAIs is the same as treating any other type of infection, with the appropriate antibiotics. But treatment can be more difficult because of pre-existing conditions and because some of the bacteria causing these infections are becoming antibiotic resistant.
The focus on healthcare-acquired infections is now on prevention. In most cases, prevention is very basic: proper hand washing and good environmental hygiene.
- All people who enter a patient’s room or touch a patient must wash their hands before and after, even if they wear gloves.
- Patient rooms, as well as common rooms and facilities need proper cleaning on a regular basis.
- Medical equipment also need proper washing and sterilization (when appropriate).
- Limit, as much as possible, invasive procedures for as short a period of time as possible.
- Healthcare providers must correctly observe sterile processes when performing procedures, such as changing wound dressings and inserting urinary catheters.
- Patients should have well-ventilated private rooms as often as possible.
- Staff should monitor patients closely for any signs of infection.
How you can reduce your risk of developing an HAI
- Ensure that everyone who comes into your room, either to provide care or just to visit, washes their hands.
- Wash your own hands frequently and thoroughly.
- Report any signs or symptoms of an infection, such as increasing redness around a wound, unexpected drainage from a wound, cloudy or foul-smelling urine, fever, chills.
- Whenever you to take an antibiotic, take it only as prescribed. This means for the full duration of the prescription, even if you feel like your infection has gone away.
- Don’t use someone else’s antibiotic to treat what you think might be an infection.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Suggested Citation: Sepsis Alliance. Sepsis and Healthcare-Acquired Infections (HAIs). 2022. https://www.sepsis.org/sepsisand/healthcare-acquired-infections/
Updated March 8, 2022.