A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a healthcare–associated infection. Such an infection can be acquired in hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. Infection is spread to the susceptible patient in the clinical setting by various means. Health care staff also spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting. An easy way to understand the term is that the infection tends to lack evidence that it was incubating, or present when the patient entered the healthcare setting, thus meaning it was acquired post-admission. Effects In the United States, the Centers for Disease Control and Prevention estimated that roughly 1.7 million healthcare-associated infections, from all types of microorganisms, including bacteria and fungi combined, cause or contribute to 99,000 deaths each year. In Europe, where hospital surveys have been conducted, the category of gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types display antimicrobial resistance, which can complicate treatment. In the UK about 300,000 patients were affected in 2017, and this was estimated to cost the NHS about £1 billion a year. Types Hospital-acquired pneumonia Ventilator-associated pneumonia Urinary tract infection Gastroenteritis Puerperal fever Central line-associated blood stream infection Organisms Staphylococcus aureus Methicillin resistant Staphylococcus aureus Candida albicans Pseudomonas aeruginosa Acinetobacter baumannii' Stenotrophomonas maltophilia Clostridium difficile Escherichia coli Tuberculosis Vancomycin-resistant Enterococcus Legionnaires' disease Cause Transmission In-dwelling catheters have recently been identified with hospital acquired infections. To deal with this complication, procedures are used, called intravascular antimicrobial lock therapy, that can reduce infections that are unexposed to blood-borne antibiotics. Introducing antibiotics, including ethanol, into