Imagine that you are a patient and you have to go to the hospital for a surgery or for treatment of some serious condition. You are anxious to begin with, but likely unaware that one big new risk that you may encounter during your stay is contracting an infection. Seems cruelly ironic but it happens quite frequently. CMS and others have created intensive initiatives and incentives to try to drive down the rates of these infections acquired in hospitals. And they appear to be garnering results, according to an analysis in the New England Journal of Medicine. (NEJM Article) The analysts from the Centers for Disease Control looked at changes from 2011 to 2015 in infection rates in ten states that participated in a special survey. About 3.2% of patients who were hospitalized in the 2015 survey had a health care associated infection, compared to 4% in 2011. After adjustments, patients had about a 16% less likelihood of contracting an infection in the hospital in 2015. Many infections are related to use of a catheter or other invasive device or equipment which creates a pathway for pathogens. If a patient did not have such a device, their risk of infection dropped by 24%. The most common infection was pneumonia, along with gastrointestinal infections and surgical site complications. The percentage of patients with pneumonia, GI infections or bloodstream infections did not change significantly, but their were lower percentages with surgical site or urinary tract infections. Many of these infections occurred in critical care units. Older patients, use of a ventilator or central catheter, length of stay, hospital size and rural or urban location were also linked to infection rates. While rates have declined, it is apparent that there are still many opportunities for further improvement. The survey helps by identifying where the focus should be and it appears to relate to use of invasive equipment and to pneumonia. Hospital-acquired infections are expensive to treat but they also significantly diminish the quality of life of a patient while hospitalized and pose a risk of death. They are worthy of continued substantial attention.