Healthcare Acquired Infection

Healthcare Acquired Infection (HCAI), also known as nosocomially acquired infection, is an infection that has occurred as a result of medical or surgical treatment, or contact with a healthcare setting. Patients, visitors and staff are all at risk from HCAI.

A wide range of infections are covered by the term HCAI, the most well-known are methicillin-resistant Staphylococcus aureus, known as MRSA, Clostridium difficile, known as C. difficile, methicillin sensitive Staphylococcus aureus, known as MSSA and E.coli.

The infection usually develops in the patient 48 hours or more following their admission or treatment. HCAI is different to community acquired infection which develops within the first 48 hours and is considered to have been incubating prior to admission.

Those at risk include people who:

  • are ill due to a lowered immune system
  • have had surgery due to the effect on the immune system or the tissue damage that has occurred
  • have had medical devices used, such as catheters or intravenous equipment, even if the equipment is sterilised
  • have become very ill or who remain in a healthcare setting for a long period of time
  • are very young, due to the immune system not being fully developed 
  • are an older adult, due to the increased likelihood of having other health condition
  • are receiving treatment for other conditions which causes their immune system to be suppressed


The symptoms of HCAI can range from mild to severe. All infections have the potential to be severe, depending upon the health of the patient it is possible for the infection to spread into the blood stream and lead to septicaemia and septic shock.

The impact of any infection will vary, and could lead to a longer stay in hospital, require surgery and in some cases result in the death of the patient. Bacterial infection can be treated with antibiotics. It is only possible to treat the symptoms of viruses.


Some Healthcare Acquired Infections are a result of cross-infection, where bacteria is transferred from one person to another. Good infection control practices, including enhanced cleaning, utilising single use instruments and opening isolation facilities can contribute to establishing a clean and safe healthcare environment which can help to prevent these occurrences.

The majority of infections are caused by bacteria which naturally occur on the body, either gaining access through surgery to areas which are normally sterile or overcoming the immune system as a result of illness, which can be difficult to prevent. 

Overuse of antibiotics can contribute to the spread of antibiotic resistant bacteria, nationally work is underway to reduce inappropriate prescribing.

You should observe good hygiene when going into a healthcare setting, including regular hand washing, and using PPE as appropriate.

Do not go into a health care setting or have close contact with a person who is at risk of HCAI if you are unwell.

Reporting Healthcare Infections

The local Public Health - Health Protection Team for North and West Northamptonshire work closely with UKHSA (UK Health Security Agency), using routine surveillance programmes to monitor certain infections in healthcare settings and the spread of resistant infection, and providing support to prevent and control infection in establishments such as hospitals, care homes and schools.

Healthcare Infections are notifiable in England. It is important the health professionals inform East Midlands UK Health Security Agency (UKHSA) of any cases for early identification and management of cases to prevent onward transmission of this infection.

Contact details for East Midlands UKHSA

Telephone: 0344 2254 524 (option 1)
Email: [email protected] 

These are not constantly monitored out of hours.

Further information

Last updated 03 October 2022