PATTERNS OF HEALTHCARE-ASSOCIATED INFECTIONS ACROSS ACUTE CARE HOSPITALS.
Main Article Content
Keywords
healthcare-associated infections, acute care hospitals, antimicrobial resistance, infection surveillance, infection prevention
Abstract
Healthcare-associated infections (HAIs) remain a major patient-safety challenge in acute care hospitals, where invasive procedures, vulnerable patient populations, antimicrobial exposure, and complex care pathways create sustained opportunities for transmission. This review synthesizes current evidence on the epidemiology, major infection types, etiological profiles, determinants, surveillance approaches, diagnostic advances, and prevention strategies associated with HAIs. The burden varies widely across regions, hospital units, and patient groups, with intensive care, surgery, prolonged hospitalization, and device use consistently associated with higher risk. Central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, surgical site infections, and Clostridioides difficile infection remain prominent, while multidrug-resistant bacteria, opportunistic fungi, and biofilm-forming organisms increasingly complicate management. HAI patterns arise from interacting patient, microbial, environmental, workforce, and institutional factors. Electronic surveillance, molecular diagnostics, whole-genome sequencing, and artificial intelligence offer important gains in detection and outbreak investigation, although their implementation depends on data quality, infrastructure, and technical capacity. Effective control continues to rely on hand hygiene, device stewardship, environmental cleaning, antimicrobial stewardship, staff education, audit and feedback, and accountable leadership. Future progress will require integrated, context-sensitive prevention programs that link surveillance directly to action and ensure equitable access to both established and emerging technologies.
References
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28. Nekkab, N., Astagneau, P., Temime, L., & Crépey, P. (2017). Spread of hospital-acquired infections: A comparison of healthcare networks. PLoS computational biology, 13(8), e1005666.
29. Percival, S. L., Suleman, L., Vuotto, C., & Donelli, G. (2015). Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control. Journal of medical microbiology, 64(4), 323-334.
30. Price, L., MacDonald, J., Melone, L., Howe, T., Flowers, P., Currie, K., ... & Reilly, J. (2018). Effectiveness of national and subnational infection prevention and control interventions in high-income and upper-middle-income countries: a systematic review. The Lancet Infectious Diseases, 18(5), e159-e171.
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32. Russo, P. L., Stewardson, A. J., Cheng, A. C., Bucknall, T., & Mitchell, B. G. (2019). The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrobial Resistance & Infection Control, 8(1), 114.
33. Schreiber, P. W., Sax, H., Wolfensberger, A., Clack, L., & Kuster, S. P. (2018). The preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis. Infection Control & Hospital Epidemiology, 39(11), 1277-1295.
34. Shahida, S. M., Islam, A., Dey, B., Islam, F., Venkatesh, K., & Goodman, A. (2016). Hospital acquired infections in low and middle income countries: root cause analysis and the development of infection control practices in Bangladesh.
35. Shuman, E. K., & Chenoweth, C. E. (2018). Urinary catheter-associated infections. Infectious Disease Clinics, 32(4), 885-897.
36. Sips, M. E., Bonten, M. J., & van Mourik, M. S. (2017). Automated surveillance of healthcare-associated infections: state of the art. Current opinion in infectious diseases, 30(4), 425-431.
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38. Van Mourik, M. S., Perencevich, E. N., Gastmeier, P., & Bonten, M. J. (2018). Designing surveillance of healthcare-associated infections in the era of automation and reporting mandates. Clinical Infectious Diseases, 66(6), 970-976.
39. Wang, Y., Xu, C., Zhang, S., Yang, L., Wang, Z., Zhu, Y., & Yuan, J. (2019). Development and evaluation of a deep learning approach for modeling seasonality and trends in hand-foot-mouth disease incidence in mainland China. Scientific reports, 9(1), 8046.
40. Yokoe, D. S., Anderson, D. J., Berenholtz, S. M., Calfee, D. P., Dubberke, E. R., Ellingson, K. D., ... & Maragakis, L. L. (2014). A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infection Control & Hospital Epidemiology, 35(8), 967-977.
41. Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., ... & Pittet, D. (2015). systematic review and evidence-based guidance on organization of hospital infection control programmes (SIGHT) study group. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis, 15(2), 212-24.
42. Zumla, A., Al-Tawfiq, J. A., Enne, V. I., Kidd, M., Drosten, C., Breuer, J., ... & Gant, V. (2014). Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections—needs, advances, and future prospects. The Lancet Infectious Diseases, 14(11), 1123-1135.
2. Allegranzi, B., Nejad, S. B., & Pittet, D. (2017). The burden of healthcare‐associated infection. Hand hygiene: a handbook for medical professionals, 1-7.
3. Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., ... & Duane, T. M. (2017). American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. Journal of the American College of Surgeons, 224(1), 59-74.
4. Bell, T., & O’Grady, N. (2017). Prevention of central line-associated bloodstream infections. Infectious disease clinics of North America, 31(3), 551.
5. Branch-Elliman, W., Price, C. S., Bessesen, M. T., & Perl, T. M. (2015). Using the pillars of infection prevention to build an effective program for reducing the transmission of emerging and reemerging infections. Current environmental health reports, 2(3), 226-235.
6. Cai, Y., Venkatachalam, I., Tee, N. W., Tan, T. Y., Kurup, A., Wong, S. Y., ... & Marimuthu, K. (2017). Prevalence of healthcare-associated infections and antimicrobial use among adult inpatients in Singapore acute-care hospitals: results from the first national point prevalence survey. Clinical Infectious Diseases, 64(suppl_2), S61-S67.
7. Cortese, Y. J., Wagner, V. E., Tierney, M., Devine, D., & Fogarty, A. (2018). Review of catheter‐associated urinary tract infections and in vitro urinary tract models. Journal of healthcare engineering, 2018(1), 2986742.
8. Danasekaran, R., Mani, G., & Annadurai, K. (2014). Prevention of healthcare-associated infections: protecting patients, saving lives. Int J Community Med Public Health, 1(1), 67-68.
9. de Bruin, J. S., Seeling, W., & Schuh, C. (2014). Data use and effectiveness in electronic surveillance of healthcare associated infections in the 21st century: a systematic review. Journal of the American Medical Informatics Association, 21(5), 942-951.
10. Facciolà, A., Pellicano, G. F., Visalli, G., Paolucci, I. A., Venanzi Rullo, E., Ceccarelli, M., ... & La Fauci, V. (2019). The role of the hospital environment in the healthcare-associated infections: a general review of the literature. European Review for Medical & Pharmacological Sciences, 23(3).
11. Fernando, S. A., Gray, T. J., & Gottlieb, T. (2017). Healthcare‐acquired infections: prevention strategies. Internal medicine journal, 47(12), 1341-1351.
12. Gajdács, M., & Urbán, E. (2019). Prevalence and antibiotic resistance of Stenotrophomonas maltophilia in respiratory tract samples: a 10-year epidemiological snapshot. Health services research and managerial epidemiology, 6, 2333392819870774.
13. Guery, B., Galperine, T., & Barbut, F. (2019). Clostridioides difficile: diagnosis and treatments. Bmj, 366.
14. Harbarth, S., Balkhy, H. H., Goossens, H., Jarlier, V., Kluytmans, J., Laxminarayan, R., ... & World Healthcare-Associated Infections Resistance Forum participants. (2015). Antimicrobial resistance: one world, one fight!. Antimicrobial Resistance and Infection Control, 4(1), 49.
15. Iliyasu, G., Dayyab, F. M., Habib, Z. G., Tiamiyu, A. B., Abubakar, S., Mijinyawa, M. S., & Habib, A. G. (2016). Knowledge and practices of infection control among healthcare workers in a Tertiary Referral Center in North-Western Nigeria. Annals of African medicine, 15(1), 34-40.
16. Kallet, R. H. (2015). The vexing problem of ventilator-associated pneumonia: observations on pathophysiology, public policy, and clinical science. Respiratory Care, 60(10), 1495-1508.
17. Kärki, T., Plachouras, D., Cassini, A., & Suetens, C. (2019). Burden of healthcare-associated infections in European acute care hospitals. Wiener Medizinische Wochenschrift, 169(Suppl 1), 3-5.
18. Khan, H. A., Baig, F. K., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific journal of tropical biomedicine, 7(5), 478-482.
19. Knisely, J. M., Liu, B., Ranallo, R. T., & Zou, L. (2016). Vaccines for healthcare-associated infections: promise and challenge. Clinical infectious diseases, 63(5), 657-662.
20. Kołpa, M., Wałaszek, M., Różańska, A., Wolak, Z., & Wójkowska-Mach, J. (2018). Hospital-wide surveillance of healthcare-associated infections as a source of information about specific hospital needs. A 5-year observation in a multiprofile provincial hospital in the south of Poland. International Journal of Environmental Research and Public Health, 15(9), 1956.
21. Kritsotakis, E. I., Kontopidou, F., Astrinaki, E., Roumbelaki, M., Ioannidou, E., & Gikas, A. (2017). Prevalence, incidence burden, and clinical impact of healthcare-associated infections and antimicrobial resistance: a national prevalent cohort study in acute care hospitals in Greece. Infection and drug resistance, 317-328.
22. Kuppelwieser, B., Berktold, M., Orth-Höller, D., & Lass-Flörl, C. (2018). Control of hospital-acquired infections in Austria. Wiener klinische Wochenschrift, 130(21), 673-679.
23. Lin, K. Y., Cheng, A., Chang, Y. C., Hung, M. C., Wang, J. T., Sheng, W. H., ... & Chang, S. C. (2017). Central line-associated bloodstream infections among critically-ill patients in the era of bundle care. Journal of Microbiology, Immunology and Infection, 50(3), 339-348.
24. Magill, S. S., O’Leary, E., Janelle, S. J., Thompson, D. L., Dumyati, G., Nadle, J., ... & Edwards, J. R. (2018). Changes in prevalence of health care–associated infections in US hospitals. New England Journal of Medicine, 379(18), 1732-1744.
25. Mahomed, S., Mahomed, O., Sturm, A. W., Knight, S., & Moodley, P. (2017). Challenges With Surveillance of Healthcare‐Associated Infections in Intensive Care Units in South Africa. Critical care research and practice, 2017(1), 7296317.
26. Mirande, C., Bizine, I., Giannetti, A., Picot, N., & van Belkum, A. (2018). Epidemiological aspects of healthcare-associated infections and microbial genomics. European Journal of Clinical Microbiology & Infectious Diseases, 37(5), 823-831.
27. Musu, M., Lai, A., Mereu, N. M., Galletta, M., Campagna, M., Tidore, M., ... & Coppola, R. C. (2017). Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units. Journal of preventive medicine and hygiene, 58(3), E231.
28. Nekkab, N., Astagneau, P., Temime, L., & Crépey, P. (2017). Spread of hospital-acquired infections: A comparison of healthcare networks. PLoS computational biology, 13(8), e1005666.
29. Percival, S. L., Suleman, L., Vuotto, C., & Donelli, G. (2015). Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control. Journal of medical microbiology, 64(4), 323-334.
30. Price, L., MacDonald, J., Melone, L., Howe, T., Flowers, P., Currie, K., ... & Reilly, J. (2018). Effectiveness of national and subnational infection prevention and control interventions in high-income and upper-middle-income countries: a systematic review. The Lancet Infectious Diseases, 18(5), e159-e171.
31. Rawson, T. M., Ahmad, R., Toumazou, C., Georgiou, P., & Holmes, A. H. (2019). Artificial intelligence can improve decision-making in infection management. Nature human behaviour, 3(6), 543-545.
32. Russo, P. L., Stewardson, A. J., Cheng, A. C., Bucknall, T., & Mitchell, B. G. (2019). The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrobial Resistance & Infection Control, 8(1), 114.
33. Schreiber, P. W., Sax, H., Wolfensberger, A., Clack, L., & Kuster, S. P. (2018). The preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis. Infection Control & Hospital Epidemiology, 39(11), 1277-1295.
34. Shahida, S. M., Islam, A., Dey, B., Islam, F., Venkatesh, K., & Goodman, A. (2016). Hospital acquired infections in low and middle income countries: root cause analysis and the development of infection control practices in Bangladesh.
35. Shuman, E. K., & Chenoweth, C. E. (2018). Urinary catheter-associated infections. Infectious Disease Clinics, 32(4), 885-897.
36. Sips, M. E., Bonten, M. J., & van Mourik, M. S. (2017). Automated surveillance of healthcare-associated infections: state of the art. Current opinion in infectious diseases, 30(4), 425-431.
37. Swaminathan, S., Prasad, J., Dhariwal, A. C., Guleria, R., Misra, M. C., Malhotra, R., ... & Srikantiah, P. (2017). Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in India. bmj, 358.
38. Van Mourik, M. S., Perencevich, E. N., Gastmeier, P., & Bonten, M. J. (2018). Designing surveillance of healthcare-associated infections in the era of automation and reporting mandates. Clinical Infectious Diseases, 66(6), 970-976.
39. Wang, Y., Xu, C., Zhang, S., Yang, L., Wang, Z., Zhu, Y., & Yuan, J. (2019). Development and evaluation of a deep learning approach for modeling seasonality and trends in hand-foot-mouth disease incidence in mainland China. Scientific reports, 9(1), 8046.
40. Yokoe, D. S., Anderson, D. J., Berenholtz, S. M., Calfee, D. P., Dubberke, E. R., Ellingson, K. D., ... & Maragakis, L. L. (2014). A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infection Control & Hospital Epidemiology, 35(8), 967-977.
41. Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., ... & Pittet, D. (2015). systematic review and evidence-based guidance on organization of hospital infection control programmes (SIGHT) study group. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis, 15(2), 212-24.
42. Zumla, A., Al-Tawfiq, J. A., Enne, V. I., Kidd, M., Drosten, C., Breuer, J., ... & Gant, V. (2014). Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections—needs, advances, and future prospects. The Lancet Infectious Diseases, 14(11), 1123-1135.
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Dec 20, 2022
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Dr Rajesh Kumar Rajvanshi, & Dr Benika Kajla. (2022). PATTERNS OF HEALTHCARE-ASSOCIATED INFECTIONS ACROSS ACUTE CARE HOSPITALS . Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 5810-5822. https://doi.org/10.69980/gvd7by70
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Author Biographies
Dr Rajesh Kumar Rajvanshi
Assistant professor MICROBIOLOGY Rama Medical College Hosital and Research center , Hapur
Dr Benika Kajla.
Assistant Professor Microbiology Varun Arjun Medical College and Rohailkhand Hospital
Shahjahanpur
How to Cite
Dr Rajesh Kumar Rajvanshi, & Dr Benika Kajla. (2022). PATTERNS OF HEALTHCARE-ASSOCIATED INFECTIONS ACROSS ACUTE CARE HOSPITALS . Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 5810-5822. https://doi.org/10.69980/gvd7by70
