2018 National and State Healthcare-Associated Infections (HAI) Progress Report

    November 2019

    The 2018 HAI Progress Report highlights significant progress in reducing some HAIs, while identifying areas where more improvements are needed. Between 2017 and 2018, significant national reductions in acute care hospitals (ACH) were seen in central line-associated bloodstream infections (CLABSI, 9%), catheter-associated urinary tract infections (CAUTI, 8%), and hospital-onset C. difficile infection (CDI, 12%), while no significant change was observed in hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, ventilator-associated events (VAE), and surgical site infections (SSIs) related to 10 select procedures. In long-term acute care hospitals (LTACHs), significant reductions were seen in CAUTI (7%), hospital-onset CDI (18%), and hospital-onset MRSA bacteremia (21%) while no significant changes were observed in CLABSI (3%) and VAE (6%). In inpatient rehabilitation facilities (IRFs), a significant reduction was seen in hospital-onset CDI (20%) while no significant changes were seen in CLABSI, CAUTI, and MRSA bacteremia. The national progress in reducing HAIs shows that prevention is possible. Ongoing collaboration between public health, healthcare professionals, and other partners is critical to ensuring patient safety.

    2018 Standardized Infection Ratios by State

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    This map displays the variation in CLABSI SIRs across the United States for general acute care hospitals in 2018. States with insufficient data reported for the selected year or hospital type are displayed in white.

    2018 National HAI Progress Report

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    • HAI Progress Increase, SIR is significantly higher (worse) than comparison group.
    • HAI Progress No Change, SIR increase or decrease is not significantly different than comparison group.
    • HAI Progress Decrease, SIR is significantly lower (better) than comparison group.
    • HAI Progress Significant Increase, Significant increase from the previous year.
    • HAI Progress No Change, No significant change from the previous year.
    • HAI Progress Significant Decrease, Significant decrease from the previous year.

    decrease 26%, Lower Compared to Nat'l Baseline

    Central Line-Associated Bloodstream Infections

    When a tube is placed in a large vein and not put in correctly or kept clean, it can become a way for germs to enter the body and cause deadly infections in the blood.

    Key Data Points

    • decrease, National ACHs reported a significant decrease in CLABSIs between 2017 and 2018
    • 8%
      , Among the 2,330 national ACHs with enough data to calculate an SIR, 8% had an SIR significantly higher (worse) than 0.74, the value of the national SIR.

    National Data for General Acute Care Hospitals, Year 2018

    2018 National SIR Progress

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    Select visualization:

    Healthcare-associated infections (HAIs) are infections patients can get while receiving medical treatment in a healthcare facility. Working toward the elimination of HAIs is a CDC priority. The standardized infection ratio (SIR) is a summary statistic that can be used to track HAI prevention progress over time; lower SIRs are better. The infection data are reported to CDC’s National Healthcare Safety Network (NHSN). HAI data for nearly all U.S. hospitals are published on the Hospital Compare website. This report is based on 2018 data, published in 2019 and uses the 2015 Baseline and risk-adjusted models.

      Additional Resources:

    1. 2018 National and State Healthcare-Associated Infections Progress Report
    2. Magill SS et al. Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. N Engl J Med. 2018 Nov 1;379(18):1732-1744. doi: 10.1056/NEJMoa1801550.
    3. Magill SS et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014 Mar 27;370(13):1198-208. doi: 10.1056/NEJMoa1306801.
    4. Data Summary of HAIs in the US: Assessing Progress 2006-2016


    • The number of hospitals that reported to NHSN and are included in the SIR calculation. This number may vary across HAI types; for example, some hospitals do not use central lines or urinary catheters, or do not perform colon or abdominal hysterectomy surgeries.