HEALTHCARE-ASSOCIATED INFECTIONS (HAIs)

Healthcare-associated infections (HAIs), together with antimicrobial resistance, represent one of the major challenges for Public Health and significantly affect the quality and safety of healthcare delivery. Their impact on morbidity and mortality has been well documented, including the economic burden on society [1, 4].
The World Health Organization identifies healthcare-associated infections as the most frequent adverse event during the delivery of healthcare services, with an increasing epidemiological trend and a significant clinical and economic impact, resulting in higher direct and indirect costs due to prolonged hospital stays, long-term disability, and increased mortality [2].
The 2016–2017 point prevalence survey conducted by the European Centre for Disease Prevention and Control reported that 8.9 million HAIs occur each year in European acute and long-term care facilities [3].
Each year, 2,609,911 new cases of healthcare-associated infections occur in the European Union and the European Economic Area. The cumulative burden of six HAIs has been estimated at 501 disability-adjusted life years (DALYs) per 100,000 inhabitants, with over 90,000 deaths annually [4].
Each year in the European Union, 426,277 nosocomial infections are caused by antimicrobial-resistant microorganisms. Deaths attributable to antimicrobial-resistant microorganisms have been estimated at 33,110 per year [5].
The COVID-19 pandemic has highlighted the extent to which healthcare facilities can contribute to the spread of infections, harming patients, healthcare workers, and visitors if insufficient attention is paid to infection prevention and control [10].
HAIs are potentially preventable if effective infection prevention and control (IPC) interventions are implemented, with reported reductions ranging from 35% to 55% [6, 7]. According to the World Health Organization, in facilities where proper hand hygiene and other cost-effective practices are followed, up to 70% of these infections can be prevented [10].
Improvements in IPC at both national and facility levels are essential for successfully containing antimicrobial resistance and preventing HAIs, including outbreaks of highly transmissible diseases, through the provision of high-quality care within the framework of universal health coverage [8].
The scale and severity of the current situation cannot be addressed without a more centralized global approach, including the establishment of a minimum gold standard for the mandatory implementation of infection control measures, the definition of curricula on infection control and antimicrobial stewardship to be mandatorily included in medical schools, and the development of appropriate indicators to monitor the implementation and effectiveness of interventions [9].