Current HAI Progress Report

2018 National and State Healthcare-Associated Infections Progress Report

Table of Contents

Executive Summary

The Centers for Disease Control and Prevention (CDC) is committed to protecting patients and healthcare personnel from adverse healthcare events and promoting safety, quality, and value in healthcare delivery. Preventing healthcare-associated infections (HAIs) is a top priority for CDC and its partners in public health and healthcare. The 2018 National and State Healthcare-Associated Infections (HAI) Progress Report provides a summary of select HAIs across four healthcare settings; acute care hospitals (ACHs), critical access hospitals (CAHs), inpatient rehabilitation facilities (IRFs) and long-term acute care hospitals (LTACHs). Data from CAHs are provided in the detailed technical tables but not in the report itself. The designation of CAH is assigned by the Centers for Medicare and Medicaid Services (CMS) to hospitals that have 25 or fewer acute care inpatient beds and that maintain an annual average length of stay of 96 hours or less for acute care patients. IRFs include hospitals, or part of a hospital, that provide intensive rehabilitation services using an interdisciplinary team approach. LTACHs provide treatment for patients who are generally very sick and stay, on average, more than 25 days. To view HAI data from individual hospitals, LTACHs and IRFs, please see: CMS Hospital Compare, LTACH Compare, and IRF Compare.

Access this report in the Antibiotic Resistance & Patient Safety Portal

This report, along with the detailed technical tables, provides national- and state-level data about HAI incidence during 2018. The report is designed to be accessible to many audiences. The national and state HAI reports will be made available for viewing, downloading, and printing from the Antibiotic Resistance & Patient Safety Portal. For detailed methods, references, and definitions please refer to the Technical Appendix and Glossary within this report. For more information, please visit CDC’s Healthcare-Associated Infection Data Reports website.

CDC’s mission in healthcare safety includes tracking infections, responding to outbreaks, providing infection prevention expertise and guidance, implementing prevention interventions in collaboration with partners, spearheading prevention research, and serving as the nation’s gold standard microbiology laboratory for the pathogens most often implicated in HAIs. CDC’s National Healthcare Safety Network (NHSN), the nation’s most widely used HAI surveillance system, is a shared resource for HAI prevention. More than 22,000 active hospitals and other healthcare facilities provide data to NHSN, which in turn is used for national- and state-level analyses, including for this HAI Report, and for targeted prevention initiatives by healthcare facilities, states, regions, quality groups, and national public health agencies, including CDC.

Executive Summary [PDF – 11 pages]

The 2018 National and State HAI Progress Report provides data on central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), surgical site infections (SSIs), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream events, and Clostridioides difficile (C. difficile) events, formerly known as Clostridium difficile. For each of the four healthcare settings, the report consists of national factsheets via the Antibiotic Resistance & Patient Safety Portal, and detailed technical tables; the national factsheets provide a high-level view of HAIs at a national level, while the technical tables include additional statistics about HAIs, reporting mandates, and data validation efforts in each state and select U.S. territories. The report’s national factsheets, as well as the detailed technical tables, include infection-specific standardized infection ratios (SIRs), which measure progress in reducing HAIs compared to the 2015 baseline time period. The SIR is the ratio of the observed number of infections (events) to the number of predicted infections (events) for a summarized time period. In addition to the SIRs, the report includes the standardized utilization ratios (SURs), which measure device use by comparing the number of observed device days to the number of predicted device days. The SIR and SUR metrics are calculated using the 2015 national baseline and risk adjustment methodology. More information about these metrics can be found at:

NHSN’s Guide to the SIR: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf [PDF – 49 pages]

NHSN’s Guide to the SUR: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sur-guide-508.pdf [PDF – 26 pages].