Patients in U.S. hospitals were less likely to have a healthcare-associated infection in 2023 than in 2015, according to a CDC study published July 15 in The New England Journal of Medicine.
On any given day in 2023, 1 in 38 patients had at least one healthcare-associated infection — down from 1 in 31 in 2015 and 1 in 25 in 2011. The share of patients with an HAI fell from 3.2% in 2015 to 2.6% in 2023.
The point-prevalence survey, led by Nora Chea, MD, of the CDC’s Division of Healthcare Quality Promotion in Atlanta, drew on medical record reviews at hospitals in 10 states through the Emerging Infections Program. Each hospital picked one survey day between May 1 and Sept. 30, 2023, and staff reviewed records for randomly selected patients from the morning census. The 2023 survey covered 13,653 patients across 218 hospitals.
Among the 151 hospitals that participated in both surveys, patients were 27% less likely to have an HAI in 2023 compared to 2015.
The decline was driven by declines in three device- and antibiotic-linked infections, according to MedPage Today‘s report on the research. The prevalence of Clostridioides difficile infection fell from 0.54% to 0.22%, central catheter-associated bloodstream infections from 0.30% to 0.16%, and catheter-associated urinary tract infections from 0.20% to 0.09%.
The authors attributed much of the C. diff drop to hospitals shifting to two-step testing, which carries higher specificity than one-step tests, and to more selective testing — avoiding patients without diarrhea, for example. C. diff was the most common pathogen in 2015 at 15.5% of HAIs; by 2023 its share had more than halved to 7.7%, and Staphylococcus aureus had become the most common pathogen at 13.8%.
Despite the progress, the burden remains high. The CDC estimated 518,000 HAIs in U.S. hospitals in 2023, affecting an estimated 471,555 patients.
Two areas showed little or no improvement. The share of patients with a surgical-site infection ticked up from 0.56% to 0.59%, and pneumonia remained the most common HAI in both years.
About 61% of HAIs in 2023 were not associated with a device or procedure, and roughly two-thirds of pneumonia cases were non-ventilator-associated — a category the authors said is hard to track because it lacks a surveillance definition built on data readily pulled from electronic health records.
The reduction in prevalence indicates continued success of prevention strategies, the researchers concluded, adding that further gains will require interventions targeting surgical-site infections and HAIs not tied to devices or procedures.
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