Hospital infections remain a substantial patient-safety challenge, but the measured burden differs by geography, facility type, infection definition, and surveillance method. WHO estimates that 7% of patients in high-income-country acute-care hospitals and 15% in low- and middle-income-country acute-care hospitals acquire at least one healthcare-associated infection (HAI) during their stay. Recent CDC data describe U.S. acute-care burden and progress, while an ECDC survey measured HAIs in European acute-care hospitals during 2022–2023.
Contents
- Global hospital-associated infection prevalence
- Recent U.S. hospital infection statistics
- U.S. acute-care changes from 2023 to 2024
- Facility and state differences in the United States
- Most common HAI types in European hospitals
- Annual European infection estimates
Global hospital-associated infection prevalence
WHO’s Global report on infection prevention and control 2024 estimates that 7% of patients in high-income-country acute-care hospitals acquire at least one HAI during their stay. The comparable estimate for low- and middle-income-country acute-care hospitals is 15%. These figures come from the latest available evidence used in the 2024 report, so they describe broad patient risk across different health systems rather than a single worldwide point-prevalence survey. WHO, Global report on infection prevention and control 2024
The same WHO report cites a 2005 review estimating that up to 30% of intensive-care patients can be affected by HAIs. That review also reported HAI incidence two to 20 times higher in low- and middle-income countries than in high-income countries. These are legacy findings cited by the 2024 report, not newly measured 2024 results.
HAIs are also closely connected with sepsis. WHO’s 2024 report says approximately 23.6% of hospital-treated sepsis cases are healthcare-associated. Among sepsis cases with organ dysfunction treated in adult intensive-care units, healthcare-associated cases account for 48.7%. A pooled analysis estimated mortality at 24.4% among people with healthcare-associated sepsis, rising to 52.3% when those patients are treated in an intensive-care unit.
Antimicrobial resistance adds another dimension to the global burden. WHO estimates 136 million antibiotic-resistant HAIs globally each year. This is an annual estimate and should not be compared directly with a one-day prevalence percentage or with a national surveillance count.
Recent U.S. hospital infection statistics
The CDC’s 2023 U.S. hospital prevalence survey found that 2.6% of hospitalized patients had one or more HAIs. Put another way, about 1 in 38 hospitalized U.S. patients had at least one HAI on a given day in 2023. CDC estimated 518,000 HAIs in U.S. acute-care hospitals during 2023. The prevalence percentage is a survey-day measure, while the 518,000 figure is an estimate for acute-care hospitals over the year.
Compared with the 2015 survey, patients in the 2023 U.S. survey were 27% less likely to have an HAI. The comparison indicates improvement in the measured survey prevalence, but it does not mean every infection type or every facility experienced the same change.
The 2023 U.S. estimate also shows why hospital infection statistics should not focus only on devices and procedures. Sixty-one percent of HAIs were not associated with a medical device or procedure. This CDC figure concerns the 2023 estimate and uses the scope described in the CDC release. CDC, HAIs: Reports and Data · CDC, New CDC Data Shows Decline in Healthcare-Associated Infections
U.S. acute-care changes from 2023 to 2024
The CDC’s Current HAI Progress Report tracks changes in standardized infection ratios (SIRs). An SIR compares observed infections with a predicted number based on the surveillance model; the percentages below are changes in SIRs, not raw changes in infection counts.
| Infection measure in U.S. acute-care hospitals | Change from 2023 to 2024 |
|---|---|
| Central line-associated bloodstream infection (CLABSI) SIR | 9% decrease |
| Catheter-associated urinary tract infection (CAUTI) SIR | 10% decrease |
| Ventilator-associated event (VAE) SIR | 2% decrease |
| Colon-surgery surgical-site infection SIR | 4% decrease |
| Hospital-onset MRSA bacteremia SIR | 7% decrease |
| Hospital-onset Clostridioides difficile infection SIR | 11% decrease |
| Abdominal-hysterectomy surgical-site infection SIR | 8% increase |
The largest listed decrease in the 2023–2024 acute-care comparison was the 11% fall in hospital-onset C. difficile infection SIR. CAUTI SIR fell 10%, and CLABSI SIR fell 9%. Hospital-onset MRSA bacteremia SIR decreased 7%, colon-surgery SSI SIR decreased 4%, and VAE SIR decreased 2%.
The direction was not uniform. Abdominal-hysterectomy SSI SIR rose 8% from 2023 to 2024. Because these are standardized ratios, the results describe relative performance against the relevant predicted baseline; they should not be read as a claim that raw case counts changed by exactly the same percentages. CDC, Current HAI Progress Report
Facility and state differences in the United States
Infection trends varied by facility type. In U.S. inpatient rehabilitation facilities, hospital-onset C. difficile infection fell 18% from 2023 to 2024, while CAUTI fell 8%. In U.S. long-term acute-care hospitals, VAE fell 23% and hospital-onset C. difficile infection fell 15% over the same period.
These facility-specific changes are not interchangeable with the acute-care-hospital results. They concern different surveillance settings and patient populations, even when the infection measure has a similar name.
The CDC’s 2024 acute-care-hospital comparison also found broad but uneven state performance against the 2015 national baseline. Fifty U.S. states performed better than that baseline on at least two infection types, while three states performed worse on two or more types.
The number of states with ratios better than the 2015 national baseline differed by infection type:
| Infection type | States with a better ratio than the 2015 baseline in 2024 |
|---|---|
| CLABSI | 46 |
| CAUTI | 46 |
| VAE | 11 |
| Abdominal-hysterectomy SSI | 3 |
| Colon-surgery SSI | 21 |
| MRSA bacteremia | 42 |
| C. difficile infection | 51 states and territories |
The state comparisons show especially different patterns across measures. Forty-six states had acute-care-hospital CLABSI ratios better than the 2015 national baseline, and the same number had better CAUTI ratios. By contrast, 11 states had better VAE ratios, three had better abdominal-hysterectomy SSI ratios, and 21 had better colon-surgery SSI ratios. Forty-two states had better MRSA-bacteremia ratios. The C. difficile comparison included states and territories: 51 had ratios better than the 2015 baseline.
Most common HAI types in European hospitals
The ECDC point-prevalence survey of European acute-care hospitals measured patients in participating hospitals on survey days during 2022–2023. At least one HAI was found in 7.1% of 293,581 patients, with a 95% confidence interval of 7.0% to 7.2%. Among survey patients with an HAI, 91.2% had one HAI on the survey day, 8.3% had two, and 0.5% had three or more. The average was 1.09 HAIs per infected patient.
Ninety-three percent of European survey patients with an HAI were receiving at least one antimicrobial agent on the survey day. The distribution of reported infection types was led by pneumonia and lower-respiratory-tract infections, which represented 29.3% of HAIs. COVID-19 accounted for 24.0% of pneumonia and lower-respiratory-tract infections and 7.0% of all HAIs in the survey.
| HAI type in European acute-care hospitals | Share of reported HAIs |
|---|---|
| Pneumonia and lower-respiratory-tract infections | 29.3% |
| Urinary-tract infections | 19.2% |
| Surgical-site infections | 16.1% |
| Bloodstream infections | 11.9% |
| Gastrointestinal infections | 9.5% |
| C. difficile infections | 5.9% |
| Skin and soft-tissue infections | 3.7% |
Urinary-tract infections were the second-largest listed category at 19.2% of reported European HAIs. Surgical-site infections represented 16.1%, bloodstream infections 11.9%, and gastrointestinal infections 9.5%. C. difficile infections represented 5.9%, while skin and soft-tissue infections represented 3.7%.
These percentages describe the mix of HAIs reported in the 2022–2023 survey, not the probability that an individual patient will develop each infection type during a full hospital stay. ECDC, Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals 2022–2023
Annual European infection estimates
Using the 2022–2023 survey, ECDC estimated 4.8 million HAI episodes per year in EU/EEA acute-care hospitals after validation correction. The 95% cumulative-confidence range was 3.2 million to 7.6 million annual episodes. These are survey-based extrapolations from observations on survey days, rather than a continuous census of every infection throughout the year.
ECDC’s estimated annual totals for selected infection types were 769,336 urinary-tract infections, 639,674 pneumonia infections, 356,393 surgical-site infections, and 357,531 bloodstream infections in EU/EEA acute-care hospitals.
| Estimated annual burden in EU/EEA acute-care hospitals | ECDC estimate |
|---|---|
| All HAI episodes, after validation correction | 4.8 million |
| Urinary-tract infections | 769,336 |
| Pneumonia infections | 639,674 |
| Bloodstream infections | 357,531 |
| Surgical-site infections | 356,393 |
The European estimates also quantify antimicrobial resistance. ECDC estimated that 262,833 patients per year acquire an HAI involving at least one antimicrobial-resistant bacterium in EU/EEA acute-care hospitals. The estimate for patients acquiring an HAI involving a carbapenem-resistant Enterobacterales organism was 41,641 per year. ECDC estimated 174,427 HAIs per year involving Enterobacterales resistant to third-generation cephalosporins.
The resistant-infection totals are uncorrected for missing microbiology and therefore may underestimate the burden. The annual figures should also be kept separate from the 7.1% survey-day prevalence: the former extrapolate annual episodes, while the latter measures patients in participating acute-care hospitals on survey days. These descriptive statistics provide context for infection prevention and surveillance, but they are not medical advice.