Objectives.To estimate the cost of healthcare‐associated infections (HAIs) in a network of 28 community hospitals and to compare this sum to the amount budgeted for infection control programs at each institution and for the entire network.

Design.We reviewed literature published since 1985 to estimate costs for specific HAIs. Using these estimates, we determined the costs attributable to specific HAIs in a network of 28 hospitals during a 1‐year period (January 1 through December 31, 2004). Cost‐saving models based on reductions in HAIs were calculated.

Setting.Twenty‐eight community hospitals in the southeastern region of the United States.

Results.The weight‐adjusted mean cost estimates for HAIs were $25,072 per episode of ventilator‐associated pneumonia, $23,242 per nosocomial blood stream infection, $10,443 per surgical site infection, and $758 per catheter‐associated urinary tract infection. The median annual cost of HAIs per hospital was $594,683 (interquartile range [IQR], $299,057‐$1,287,499). The total annual cost of HAIs for the 28 hospitals was greater than $26 million. Hospitals budgeted a median of $129,000 (IQR, $92,500‐$200,000) for infection control; the median annual cost of HAIs was 4.6 (IQR, 3.4‐8.0) times the amount budgeted for infection control. An annual reduction in HAIs of 25% could save each hospital a median of $148,667 (IQR, $74,763‐$296,861) and could save the group of hospitals more than $6.5 million.

Conclusions.The economic cost of HAIs in our group of 28 study hospitals was enormous. In the modern age of infection control and patient safety, the cost‐control ratio will become the key component of successful infection control programs.