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CDC

National Healthcare Safety Network

Healthcare-Associated Infections in Dialysis

National Standard Infection Ratio for Bloodstream Infection Events

0.32

Fewer BSIs were observed than predicted in 2025, based on 2014 national aggregate data

National Crude Rate for Intravenous Antibiotic Starts Events in 2025

1.77

events (per 100 patient-months)

National Crude Rate for Pus, Redness, or Increased Swelling Events in 2025

0.54

events (per 100 patient-months)

Dialysis Data Profile (NHSN)

Healthcare-Associated Infections in Dialysis

Approximately 500,000 patients are treated with maintenance hemodialysis in the United States. Hemodialysis requires a mechanism for vascular access so that a person's blood circulation can be connected to a dialysis machine to filter and remove waste products and excess fluid from the body. There are three main vascular access types: fistula, graft, and central venous catheter. Patients on maintenance hemodialysis have an increased risk of infection due to an impaired immune system and frequent use of catheters or insertion of needles to access the blood circulation. Because of frequent hospitalizations and receipt of antimicrobial drugs, hemodialysis patients are also at high risk for infection with antimicrobial-resistant bacteria. Measuring and tracking rates of infection and infection-related events (such as Bloodstream Infections [BSI], Intravenous Antibiotic Starts [IVAS], Pus, Redness, or increased Swelling [PRS]) is an important part of prevention.

Years Included
2019 - 2025
Resources

Geographic Location

DIALYSIS DATA BY EVENT TYPE AND STATE

The data in this graph are limited to information that was reported by dialysis facilities to NHSN for the calendar year 2025. Data displayed are SIRs for BSIs and crude rates for IVAS and PRS by state. Data are not displayed if data are insufficient to produce an SIR or rate.

DIALYSIS DATA BY BSI AND STATE IN 2025

DIALYSIS DATA BY BSI AND STATE IN 2025
Locationvalue
AlaskaInsufficient Data
Alabama0.27
Arkansas0.49
American SamoaInsufficient Data
Arizona0.27
California0.31
Colorado0.32
Connecticut0.45
District of Columbia0.27
Delaware0.27
Florida0.26
Georgia0.24
GuamInsufficient Data
Hawaii0.56
Iowa0.38
Idaho0.34
Illinois0.23
Indiana0.27
Kansas0.25
Kentucky0.24
Louisiana0.32
Massachusetts0.35
Maryland0.34
Maine0.61
Michigan0.38
Minnesota0.4
Missouri0.29
Northern Mariana IslandsInsufficient Data
Mississippi0.45
Montana0.22
North Carolina0.48
North Dakota0.84
Nebraska0.46
New Hampshire0.29
New Jersey0.34
New Mexico0.22
Nevada0.24
New York0.33
Ohio0.4
Oklahoma0.32
Oregon0.39
Pennsylvania0.39
Puerto Rico0.19
Rhode Island0.49
South Carolina0.26
South Dakota0.82
Tennessee0.29
Texas0.26
Utah0.55
Virginia0.26
Virgin IslandsInsufficient Data
VermontInsufficient Data
Washington0.56
Wisconsin0.37
West Virginia0.22
Wyoming0.29

DIALYSIS BY EVENT TYPE AND STATE LIST

The data in this graph are limited to information that was reported by dialysis facilities to NHSN for the calendar year 2025. Data displayed are SIRs for BSIs and crude rates for IVAS and PRS by state. Data are displayed by the "*" if data are insufficient to produce an SIR or rate.

BSI SIR VALUES

BSI SIR VALUES
statevalue
Alabama0.27
Alaska*
American Samoa*
Arizona0.27
Arkansas0.49
California0.31
Colorado0.32
Connecticut0.45
Delaware0.27
District of Columbia0.27

Access Type

DIALYSIS EVENT DATA BY ACCESS TYPE

This table shows the crude rates for each HAI type - BSI, IVAS, and PRS - by each access type for 2025. Access types include the following: Central Venous Catheter (CVC) access, arteriovenous fistula access, arteriovenous graft access, or other access types such as catheter-graft hybrid devices.

DIALYSIS EVENT DATA BY ACCESS TYPE

Access TypeEventsDenominatorCrude Rate (per 100)95% CI Lower95% CI Upper
All BSI12,7184,758,5310.270.260.27
CVC8,5091,367,8420.620.610.64
Fistula2,6222,592,8380.100.100.10
Graft1,556787,4350.200.190.21
Other access3110,4160.300.210.42
All IVAS84,0244,758,5311.771.751.78
CVC47,7551,367,8423.493.463.52
Fistula25,6402,592,8380.990.981.00
Graft10,465787,4351.331.301.35
Other access16410,4161.571.351.83
All PRS25,6574,758,5310.540.530.55
CVC19,2831,367,8421.411.391.43
Fistula4,3062,592,8380.170.160.17
Graft2,040787,4350.260.250.27
Other access2810,4160.270.180.38

Footnotes

  • States with less than 10 facilities will be marked as insufficient data
  • BSI — Blood Stream Infection
  • IVAS — Intravenous Antibiotic Starts
  • PRS — Pus, Redness, or increased Swelling