Spanish Speakers at Greater Risk of Healthcare-Associated Infections

Getting an infection in the hospital is a risk for every patient but can be more so for those whose first language is Spanish, finds a recent Kaiser Permanente study. It’s also a higher risk for all non-English speaking patients with or without the use of formal interpreter services.

Kaiser Permanente reviewed 6,813 publicly reported infections at 21 of their Northern California acute care hospitals from 2019 to 2023. Their infection prevention team found that Spanish-speaking adults, compared with patients whose first language is English, experienced higher rates of central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI). Surgical site infections (SSI) increased in both adult and pediatric patients.

The use of interpreters was also linked to higher odds of acquiring infections such as CLABSI, CAUTI, and some SSI. But the use of family or friends for interpretation complicated the picture; the risk increased for all healthcare-associated infections (HAI) including infections caused by Clostridioides difficile (C. diff), Vancomycin-resistant enterococci (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA). The use of family or friends for interpretation marked non-English speaking as a risk itself for infection during hospital stay. The conclusion is that more data is needed on health inequities to understand the underlying influences that language and cultural background play in this increased risk to guide future prevention efforts.

The conclusion that health inequities are a factor in higher rates of certain kinds of infections is the focus of a Kaiser Permanente of Northern California presentation to be delivered at the 2025 Association for Professionals in Infection Control and Epidemiology (APIC) Annual Conference in Phoenix today.

“Compared with patients who speak English, Spanish speakers are at higher risk for health inequities resulting in more HAIs,” said Cristine Lacerna, DNP, RN, MPH, FAPIC, CIC, senior regional director of infection prevention at Kaiser Permanente Northern California. “Infection preventionists should utilize health inequity risk factors, among others, as a way to reduce or prevent HAIs.”“The reality of health inequities’ link to HAIs presents infection preventionists with an opportunity to not only better understand their impact on outcomes, but to identify disparities and how to mitigate them in all non-English speaking populations,” said APIC 2025 President Carol McLay DrPH, MPH, RN, FAPIC, FSHEA, CIC.