Why This Matters
Healthcare-associated infections are among the most preventable causes of serious illness and death in American hospitals. Every central-line bloodstream infection, every case of hospital-acquired C. difficile, every catheter-associated urinary tract infection is, in most cases, an outcome that could have been avoided through consistent protocol adherence, adequate staffing, and rigorous infection prevention.
For the first time in years, new federal data tell a genuinely good story about how much progress has been made — and a cautionary one about what could undo it.
The CDC's July 15, 2026 publication in the New England Journal of Medicine (DOI: 10.1056/NEJMoa2510881), led by CDC epidemiologist Dr. Nora Chea and colleagues, found that the rate of healthcare-associated infections in U.S. hospitals fell significantly between 2015 and 2023. Patients in 2023 were 27% less likely to have a healthcare-associated infection than patients in 2015. On any given day, approximately 1 in 38 hospitalized patients had at least one HAI in 2023, compared with 1 in 31 in 2015.
That represents hundreds of thousands of infections prevented and an unknowable number of deaths avoided.
What We Know So Far
The CDC survey, published simultaneously with a CDC press release on July 15, 2026, included 13,653 patients across 218 hospitals in 10 states. Trained staff reviewed medical records using National Healthcare Safety Network (NHSN)definitions to identify HAIs.
The specific findings from the 2023 NHSN Progress Report, which covers all acute care hospitals nationally (a broader base than the NEJM survey), showed that compared to 2022, U.S. acute care hospitals in 2023 saw:
- A 15% decrease in central line-associated bloodstream infections (CLABSI)
- An 11% decrease in catheter-associated urinary tract infections (CAUTI)
- A 5% decrease in ventilator-associated events
- A 16% decrease in hospital-onset MRSA bacteremia
- A 13% decrease in hospital-onset C. difficile infection
Healio reporting on the NEJM paper noted that Dr. Chea identified C. difficile reduction as "a major contributor" to the overall decline, with CDI prevalence falling from 0.54% in 2015 to 0.22% in 2023.
Despite these improvements, an estimated 518,000 HAIs still occurred in U.S. hospitals in 2023. Pneumonia, surgical site infections, and gastrointestinal infections remained the most common types, and 61% of all HAIs in 2023 were not associated with medical devices or procedures at all.
Where the Risk Remains Highest
The NEJM survey did not collect data from all U.S. hospitals; it was conducted across 218 hospitals in 10 states and is designed to be nationally representative but not exhaustive. State-level data from the NHSN Progress Report shows variation in HAI rates across states, with some states showing persistent elevation above the national baseline.
Pneumonia remains the most common HAI in acute care settings, accounting for a substantial portion of the 518,000 total. Unlike CLABSI and CAUTI, which are directly linked to device use and respond to specific bundle interventions, pneumonia prevention requires sustained nursing attention to repositioning, oral hygiene, and aspiration precautions across an entire hospitalized population.
The 61% of HAIs not associated with devices or procedures is a particularly significant finding. It suggests that the gains from device-bundle protocols, which have been a major focus of infection prevention investment, are substantial but address only part of the problem. The broader driver of HAI risk remains the density and mobility of vulnerable patients in shared clinical environments.
What Doctors and Experts Say
Dr. Chea told Healio that while the survey results are encouraging, there remains significant work ahead. "While this news is promising, there were still more than half a million HAIs in 2023. Hospitals and health care settings must continue to implement proven infection prevention and control practices and regularly review HAI surveillance data for improvement opportunities."
Public health and hospital safety experts have noted separately that the 2023 data represents the infection landscape before the most acute phase of current nursing workforce pressures took hold. Healthcare-associated infection prevention is fundamentally a human process: it depends on nurses consistently following hand hygiene protocols, monitoring catheter necessity and removal timing, conducting aspiration risk assessments, and engaging in the dozens of small daily decisions that collectively determine whether a patient contracts an infection.
When nursing ratios decline due to staffing shortages, or when nurses are managing higher patient loads due to hospital consolidation, the consistent execution of infection prevention protocols is the first thing that suffers, according to patient safety researchers. The 2023 data does not capture that dynamic fully.
What the Evidence Shows and What It Does Not
This is a national surveillance-based analysis, not a randomized trial. The improvements observed between 2015 and 2023 are consistent with the sustained implementation of evidence-based infection prevention bundles, improved antimicrobial stewardship, and the heightened infection control awareness produced by the COVID-19 pandemic. The study cannot prove causation for any specific intervention.
The 27% reduction between 2015 and 2023 is a meaningful population-level signal. The 2024 NHSN data (a separate report) shows continued improvement through 2024, with additional declines across most HAI categories, suggesting the trend is not reversing as of the most recent available data.
MedicalDaily Evidence Check
- Primary source: New England Journal of Medicine, July 15, 2026 (DOI: 10.1056/NEJMoa2510881); CDC Press Release, July 15, 2026; 2023 NHSN Progress Report
- Survey: 13,653 patients across 218 hospitals in 10 states, 2023
- What it found: 1 in 38 patients had HAI in 2023 vs. 1 in 31 in 2015; 27% reduction in adjusted odds; major declines in CLABSI, MRSA, and C. diff; 518,000 HAIs still occurred
- What it does not prove: That any specific intervention caused the decline; what will happen to HAI rates if nursing shortages intensify
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What readers should know: Real progress was made; it remains fragile and dependent on adequate nursing staffing and sustained infection control investment
Who Faces the Greatest Risk?
The patients at highest risk for healthcare-associated infections include:
- Patients with central venous catheters, urinary catheters, or mechanical ventilation, who face device-specific infection risk
- Immunocompromised patients, including those on chemotherapy, organ transplant recipients, and patients with HIV
- Elderly patients, who have reduced immune function and longer average hospital stays
- Patients in intensive care units, where device use is highest, and the patient population is most vulnerable
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Patients in facilities with below-average nursing staffing ratios, where protocol adherence is most likely to be compromised under pressure
Symptoms and Warning Signs to Watch For
Patients and their families should be alert to the following signs of possible healthcare-associated infection during or after a hospital stay:
- Fever developing during hospitalization that was not present at admission
- Redness, warmth, swelling, or discharge at any catheter insertion site or surgical wound
- New or worsening respiratory symptoms in a hospitalized patient
- Signs of sepsis: shaking chills, rapid breathing, confusion, or blood pressure drop
- Persistent diarrhea following antibiotic use, which may indicate C. difficile infection
Anyone who develops these symptoms during hospitalization should alert their nursing team immediately.
What You Can Do Now
For patients and families:
- Practice rigorous hand hygiene during hospital visits. Wash hands or use hand sanitizer every time you enter and exit a hospitalized patient's room.
- Ask the care team whether every catheter and line your loved one has is still necessary. Patients and families have the right to ask about the clinical indication for any device.
- If a post-surgical or procedure-related infection develops after discharge, report it to the treating surgeon or hospital promptly.
- Patients with planned elective hospitalizations in facilities with publicly reported infection rates can check those rates at CMS Hospital Compare .
For healthcare facilities:
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Review facility-level HAI data from the NHSN dashboard regularly, and treat any increase as an early warning signal rather than an acceptable baseline.
Cost and Access: What Patients Should Know
HAIs extend hospital stays, increase costs, and worsen outcomes. CMS has linked Hospital Compare quality reporting to value-based purchasing payment adjustments for facilities with above-average HAI rates, creating financial incentives for improvement alongside the clinical and ethical ones. Patients can access their hospital's publicly reported infection rates at CMS Hospital Compare.
What Happens Next
The 2024 NHSN Progress Report, released on the CDC HAI data page, shows continued declines across most HAI categories through 2024, suggesting the trend extends beyond the 2023 data. However, independent public health experts have cautioned that the conditions that sustained the improvement, particularly adequate nursing staffing and infection control investment, are under pressure from workforce shortages and cost-reduction initiatives that have intensified in 2025 and 2026.
The CDC and CMS have committed to continued quality reporting and benchmarking as the primary policy mechanism for sustaining progress. Whether that mechanism is sufficient in the current healthcare workforce environment is a question that the 2025 and 2026 data will begin to answer.
The Bottom Line
U.S. hospitals achieved a genuine and meaningful 27% reduction in healthcare-associated infections between 2015 and 2023, driven largely by improved infection control protocols and heightened attention to prevention during and after the COVID-19 pandemic. That progress prevented hundreds of thousands of infections. But 518,000 HAIs still occurred in 2023, nursing shortages are straining the workforce that makes infection prevention possible, and the gains are not guaranteed to continue. Hospitals that maintain staffing, enforce protocols, and treat HAI surveillance as a genuine quality priority will sustain those gains; those that do not will not.
