Hospital-acquired infections: key developments in prevention and control

Hospital-acquired infections (HAIs) are a central, but mostly preventable, concern in health care — here’s some key HAI prevention and control developments.

In 2008, a 58-year-old man presented to his local ED with neurological symptoms, including confusion, dizziness and impaired memory — the symptoms of what was later discovered to be transient ischaemic attack.¹

While he was undergoing investigations at the hospital, the man contracted an infection and, five days after admission, became febrile, dyspnoeic and tachycardic.

A blood test later confirmed he had acquired methicillin-susceptible staphylococcus aureus (MSSA) during the diagnostic process — a condition that prevented him from working in the four months thereafter.

Not an unusual case

While mainly associated with surgery, hospital-acquired infections (HAIs), including MSSA, often occur without an invasive procedure or device — and when they do occur, they prolong hospital stays by an average of 10 days.¹

In Australia, serious complications from MSSA are not particularly common, but they are from other HAIs like pneumonia, surgical site and urinary tract infections.

In fact, every year, there are an estimated 170,574 cases of the top five most common HAIs across the country and these result in around 7583 deaths.²

A HAI can occur in any healthcare setting, including a hospital, healthcare office, general practice or dental clinic, or community health facility. They can also be transmitted in any site attended by a paramedic.

While often caused by multidrug resistant organisms (MDROs), a HAI can result from exposure to any bacteria, fungus, virus, parasite or prion.

HAIs also come with a hefty price tag, with one study estimating their annual cost to be US$200 billion.³

Most are preventable

What’s more, more than half of HAI cases are believed to be preventable, with the use of evidence-based strategies.⁴

For this reason, the Australian Commission on Safety and Quality in Health Care continually refreshes its infection prevention and control (IPC) guidelines, with the latest update released last year.

The 2024 revisions emphasise risk-based approaches, antimicrobial stewardship and strong leadership to foster safety culture in healthcare settings.

Proactive, multimodal approach

Hospitals are now also required to proactively monitor and continuously improve their IPC practice, not just comply with specified mandates.

Multimodal approaches have proven particularly efficacious. These include education and training, standardised processes and maximal use of sterile barrier precautions; along with adequate skin preparation, hand hygiene and catheter care.

A study in 2006 found that such approaches could reduce rates of catheter-related bloodstream infection by 66%, and that these reductions were maintained over an 18-month period.⁶

This trumps more passive strategies, which are mainly centred on surveillance and feedback. A classic study in 1985 found that surveillance-based strategies reduced nosocomial infections by just 32%.⁷

The role of technology

In recent years technology has proved to be an important prong in a multimodal approach.

Globally, the IPC technology market is valued at USD 2.16 billion and is expected to reach USD 3.50 Billion by 2032.⁸

One option is an AI-powered electronic infection tracking system, which can identify outbreaks early and ensure staff are compliant with protocols.

Tools like hand hygiene compliance systems (HHCS) are also proving valuable. These are typically based on sound and light signals that activate when an opportunity to improve hand hygiene is detected, reminding staff, patients and visitors to sanitise their hands.

One study compared the use of HHCSs with human observation in intensive care units (ICUs) and found the technology was much more proficient at spotting these hand hygiene opportunities.⁹

Even though they recorded more opportunities than a human would, they wound up with a significantly lower rate of hand hygiene issues.

When they pilot tested the technology in the broader hospital, they recorded a reduction in catheter-associated urinary tract infections and central line-associated bloodstream infections.⁹

In high-risk settings, like ICUs and operating theatres, robotics and automation provide an added layer of protection.

These tools include ultra-violet radiation-based devices, highly dynamic robotic grippers and sensing systems and autonomous heavy-duty cleaning robots. Many also rely on dry vacuum and mopping to remove germs and pesticides.

Robots can significantly improve IPC and showed great efficacy during the COVID-19 pandemic.¹⁰

Research indicates that many hospitals avoid IPC technology due to cost, but there is mounting evidence that the healthcare burden from HAIs may significantly outweigh the cost of implementation.¹¹

Safety in numbers

Aside from technology, healthcare providers are encouraged to lean on partnerships and collaborations to ensure best practice in their IPC efforts.

During the COVID-19 pandemic, a collaboration between regional hospitals and referring nursing homes in a public health network led to a significant reduction in nursing home infections, such as urine cultures.¹²

The collaboration fostered knowledge exchange, allowing best practice IPC strategies to be shared with speed and ease.

Cross sectoral collaboration can also help providers stay privy and prepared for emerging threats.

As the world learned during COVID-19, IPC is often a moving target and one which is best tackled together.

*Amy Sarcevic is a freelance science and technical writer who regularly writes for Hospital + Healthcare. She has an academic background in psychology.

^{1. Infection Prevention and Control Practice Handbook. Section one — Healthcare Associated Infections. Clinical Excellence Commission; 2020. Accessed 23 September, 2025. https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0009/706536/Section-1-Healthcare-Associated-Infections.pdf}

^{2. Lydeamore MJ, Mitchell BG, Bucknall T, et al. Burden of five healthcare associated infections in Australia. Antimicrob Resist Infect Control. 2022;11(69). doi: 10.1186/s13756-022-01109-8}

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^{5. Australian Guidelines for the Prevention and Control of Infection in Healthcare. Australian Commission on Safety and Quality in Health Care; 2019 (updated 2024). Accessed 23 September, 2025 https://www.safetyandquality.gov.au/publications-and-resources/resource-library/australian-guidelines-prevention-and-control-infection-healthcare}

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^{7. Haley RW, Culver DH, White JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol. 1985;121(2):182–205. doi: 10.1093/oxfordjournals.aje.a113990}

^{8. Pawar, S. Global infection prevention devices market size, share, and trends analysis report — industry overview and forecast to 2032. Data Bridge Market Research; 2024. Accessed 23 September, 2025. https://www.databridgemarketresearch.com/reports/global-infection-prevention-devices-market}

^{9. McCalla S, Reilly M, Thomas R, et al. An automated hand hygiene compliance system is associated with decreased rates of health care-associated infections. Am J Infect Control. 2018;46(12):1381–1386. doi: 10.1016/j.ajic.2018.05.017}

^{10. Khan ZH, Siddique A, Lee CW. Robotics utilization for healthcare digitization in global COVID-19 management. Int J Environ Res Public Health. 2020;17(11):3819. doi: 10.3390/ijerph17113819}

^{11. Piaggio D, Zarro M, Pagliara S, et al. The use of smart environments and robots for infection prevention control: a systematic literature review. Am J Infect Control. 2023;51(10):1175–1181. doi: 10.1016/j.ajic.2023.03.005}

^{12. Jones KM, Greene MT, Meddings J, et al. Impact of a collaboration-focused intervention to prevent healthcare-associated infections before and during the COVID-19 pandemic. Clin Infect Dis. 2025;81(2):358–368. doi: 10.1093/cid/ciaf122}

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