Hospital Acquired Infections – causing human suffering and costs

Help improving healthcare all over the world

Detailed Briefing

In Europe, 1 in 15 people contracts a Hospital Acquired Infection. HAI leads to longer hospital stays and can result in death, causing significant health care costs and harming the reputation of hospitals. The main transmission route is humans. Patients and staff unconsciously spread dangerous germs. Despite all prevention measures, still more people die from HAI than from traffic accidents.

How big is the problem?

In the US, the Centers for Disease Control and Prevention (CDC) estimate roughly 1.7 million hospital-acquired infection (HAI), directly cause or contribute to 99,000 deaths each year. The European Centre for Disease Prevention and Control (ecdc) estimates that on any given day an average of 5.7% (nearly 1 in 15!) of patients in acute-care hospitals suffer from a HAI, amounting to 3.2 million patients.

According to Nationales Referenzzentrum (NRZ), in Germany there are approximately 400.000 to 600'000 patients with HAI each year, resulting in 6'000 to 15'000 death cases – this is between 2 to 5 times more than the number of road traffic fatalities!

Besides persisting health-related problems and personal harm, HAIs cause significant costs due to longer periods of hospitalization, additional examinations and treatments (on average 3’000 to 13’000 Euro per case). In Germany these direct follow-up costs are estimated to 2 billion Euro every year (indirect costs such as loss of productivity, loss of income, costs for domestic help etc. not yet considered).

Most common are catheter-associated urinary tract infections, ventilator-associated pneumonias, surgical site infections after surgery and catheter-associated bacteraemias (sepsis, blood poisoning), each making up around one fifth of the total.


What are the causes of hospital infections?

The causes for hospital infections are manifold. The following four factors are among the most important:

  1. Behavioral factors: a lack in adherence to standard medical procedures and compliance with hygiene requirements. Thereby especially proper hand hygiene is critical. Currently, only in 50-60% of required hand disinfections are performed.
  2. Environmental factors: contaminated air and surfaces in the patient’s environment lead to the spread of germs.
  3. System factors: healthcare workers suffer from high workloads and time pressure. Furthermore, fluctuation of healthcare workers is high. This leads to insufficient knowledge and adherence to key medical procedure and improper hand hygiene.
  4. Pharmacological factors: Excessive and inappropriate use of antibiotics leads to resistances in bacteria which, therefore, are becoming ever more difficult to treat – in some cases no life-saving therapies are available anymore.


Who is particularly at risk?

All hospitalized patients are susceptible to acquire a hospital infection. In general, the longer the hospital stay, the more invasive the treatment and the weaker the patient’s immune system, the higher the risk to acquire HAI. Some patient groups are particularly vulnerable to HAI:

  • Patients with severe primary diseases and compromised immune systems
  • Patients in intensive care units
  • Patients receiving invasive treatment (e.g. surgery, artificial ventilation, catheterization of the bladder, intravascular catheters, injections, etc.)
  • Newborns because of their not yet fully developed immune system


What are hospitals already doing about it?

Currently, strategies to prevent hospital acquired infections are based on a portfolio of different measures. Among others, these include:

  • Screening of patients on admission to prevent the import of resistant germs into the hospital
  • Defining and implementing standard operating procedures (SOPs) for medical procedures. Regular training of healthcare workers to adhere to these standards.
  • Applying regular hygiene routines, esp. hand hygiene and disinfection of surfaces
  • Using (sensor) technologies to remind staff disinfecting hands, but also monitor and display adherence to proper medical procedures and hand hygiene
  • Using single-use products like examination gloves, face masks, surgical gowns or other products which are just used within a particular of one patient treatment
  • Involving patients and visitors to contribute to good hygiene practices, esp. hand hygiene