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of HAIs. Although single-use medical devices have not traditionally been a
major source of infection, great strides have recently been made in treating
and preventing these types of HAIs.

6.2 Background in HAIs

HAIs affect patients or staff who are or were in a health-care facility (HCF)
but the infection was not present or incubating at the time of admission or
work. These include infections that were acquired at the HCF but that did
not appear until after discharge. Occupational infections among HCF staff
are also counted in HAIs.
HAIs are currently the most common adverse event that occurs in
health-care delivery worldwide. In developed countries 7 of every 100 hos-
pital patients will acquire at least one HAI while in the hospital. In devel-
oping countries, 10 of every 100 patients will get an HAI. Each year in the
United States, 2 million people in HCFs will acquire serious infections
from bacteria that are resistant to one or more antimicrobial agents. Of
these 2 million people, approximately 23,000 people will die as a result of
these infections. Even more people will die from other conditions that were
complicated by an HAI [1].
HAIs are a problem globally in all areas of the hospital. Data from
2002 show that on average in the European Union (EU) the average HAI
rate was 7.1% and in the United States the average was 4.5% [2]. The
rate changes significantly according to the procedure and the condition
of the patient. ICU patients have the highest incidence of infections and
are associated primarily with invasive medical devices, e.g., central venous
lines, urinary catheters, and ventilators. Newborns are another higher-risk
patient population. Surgical site infections (SSIs) are also a significant
problem especially in developing countries. Up to 30% of intensive care
unit (ICU) patients in developed countries will get at least one HAI. The
rate of infections can jump to 66% of patients with surgery in developing
countries.
HAIs are widespread, and events are under reported because many
countries do not have effective surveillance systems. HAIs are frequently
hidden from the public’s view except when high-profile incidents occur,
which capture media attention. The recent duodenoscope infections due to
re-cleaning challenges and cross infection of Ebola are prime examples of
this, but even these events quickly lose the public interest. No institution or
country can claim to have solved the problem of HAIs.