U.S. — Researchers also measured infection rates against a 2011 survey and found that patients in 2023 had a 27% lower likelihood of having a healthcare-associated infection compared to the earlier survey. In 2011, approximately one in 25 patients had a healthcare-associated infection, while in 2015 that figure was approximately one in 31 patients according to the data published in the journal.

The research was conducted through the Emerging Infections Program, which operates multiple sites across the country. Ten Emerging Infections Program sites recruited up to 25 hospitals each for the 2023 survey. Hospitals participating in the study selected a survey day between May 1, 2023, and September 30, 2023.

Medical records of randomly selected patients were reviewed to identify healthcare-associated infections. The study reviewed records of nearly 14,000 patients across 218 hospitals.

"Of just shy of 14,000 patients in 218 hospitals, 2.6% had at least one healthcare-associated infection compared with 3.2% in 2015," medical journalist Elizabeth Tracey stated. "And having a 27% less likelihood of having a healthcare-associated infection in 2023 compared to the 2011 survey is pretty remarkable," Rick Lange, president of Texas Tech Health El Paso, said.

A decrease in Clostridioides difficile infections was the major contributor to the lower prevalence of healthcare-associated infections in 2023. The decrease in Clostridioides difficile infections is attributed to increased testing, better antimicrobial stewardship, and infection control. "The major contributor to the lower prevalence was a decrease in C. diff infections in 2023," Lange said. "And that's due to increased testing, better antimicrobial stewardship, and infection control," he added.

Device-related infections also declined during the period covered by the study. The prevalence of central catheter-associated bloodstream infections decreased in 2023. "But there was also a reduction in the prevalence of central catheter-associated bloodstream infections and catheter-associated urinary tract infections as well," Lange said. Tracey noted that these either urinary or central catheter infections, so-called CAUTI or CLABSI, has declined quite a bit.

Approximately 60% of healthcare-associated infections in the study were not associated with devices or procedures. The patient population in the study was older and had longer hospital lengths of stay. "They do point out in this study that the patient population was older, so therefore more susceptible to infection, and had longer hospital lengths of stay," Tracey said. "That makes it even more striking that we've had a decrease in the prevalence of infections," Lange said.

The national burden of healthcare-associated infections exceeds 500,000 infections. "Although, when you put it in perspective, that still means the national burden exceeds over half a million infections," Lange said. Among the infections identified in the study, 46% of the staph infections were methicillin-resistant. "By looking at the type of infections and the different types of organisms involved, though, it'll allow us in the subsequent decade to focus on these sites and on these organisms," Lange said.

The national burden of healthcare-associated infections exceeds 500,000 cases, and these infections remain a persistent challenge in U.S. hospitals. The 2023 data represents the most recent large-scale assessment of infection prevalence across 218 hospitals and nearly 14,000 patients, providing a baseline for tracking progress in infection prevention. The study design, conducted through the Emerging Infections Program network and modeled after surveys from 2011 and 2015, allows for direct comparison of infection rates over a 12-year period across multiple measures including device-associated infections and Clostridioides difficile. The findings indicate that prevention strategies including antimicrobial stewardship, infection control protocols, and improved testing have contributed to measurable reductions in hospital-acquired infections despite an aging and higher-risk patient population.