Defining HAIs

What are Healthcare Associated Infections (HAIs)?

The invasion of infectious agents or toxins into the body may result in an infection. The infectious agents or toxins causing the infection varies, and may be identified using tests such as blood cultures as well as signs and symptoms (fever, for example) which will indicate the presence of an infection. A Healthcare Associated Infection (HAI) is a type of infection that patients acquire while receiving treatment in a healthcare setting that was not present or developing before admission to the facility. These healthcare settings include hospitals, clinics, long-term care facilities, and rehabilitation facilities for example. However, simply having an infection while in the hospital may not mean that the infection meets the criteria to be reported as a HAI. For the purposes of HAI reporting in Alabama, and most States, a HAI must meet the specific criteria described by the Centers of Disease Control (CDC). The criteria which define target HAIs are included in CDC's National Health Surveillance Network (NHSN) surveillance protocols and will be used for HAI data collection on units within the healthcare facility as proposed in the Alabama HAI Rules and Regulations. See “Target HAIs” below for links to the criteria for selected target HAIs.

CDC/NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections

The Causes of HAIs

HAIs may be associated with a variety of causes, including but, not limited to, the use of medical devices, such as catheters and ventilators, complications following a surgical procedure, the overuse of antibiotics, or non-adherence to infection control practices, such as hand washing.

Target HAIs

Modern healthcare employs many types of invasive devices and procedures to treat patients and to help them recover. Infections can be associated with the devices used in medical procedures, such as catheters or ventilators. Infections may also occur at surgery sites, known as surgical site infections. CDC works with ADPH to monitor and prevent these infections because they are an important threat to patient safety.

These healthcare-associated infections (HAIs) include:

• catheter-associated urinary tract infection (CAUTI);
• surgical site infection (SSI);
• central line-associated bloodstream infection (CLABSI); or
• ventilator-associated pneumonia (VAP).

Urinary tract infections (UTI) comprise the highest percentage (34%) of HAIs, followed by surgical site infections (17%), bloodstream infections (14%), and pneumonia (13%). In addition, infections associated with Clostridium difficile and Methicillin-resistant Staphylococcus aureus (MRSA) also contribute significantly to the overall problem.

See the Waging War on HAIs and the Rules and Regulations for more information about the multi-level action plans in place targeting HAIs.