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Hospital-Acquired Infections: Insights, Prevention, and Control Strategies
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Hospital-Acquired Infections: Insights, Prevention, and Control Strategies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 20 June 2026 | Viewed by 1816

Special Issue Editor

Dr. Andrea Fabbri

E-Mail Website
Guest Editor
Emergency Department, AUSL della Romagna, Forli, Italy
Interests: emergency medicine; brain injury; cardiovascular medicine; cardiology; risk stratification; acute heart failure; chest pain; cardiac arrest; sepsis; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Elderly patients are at high risk for developing healthcare-acquired infections (HAIs), increasing from 7.4% in subjects under 65 years to 11.5% in patients over 85 years. Usually, HAIs are caused by bacterial, viral, or fungal pathogens, where the most common types include bloodstream infections, hospital‐acquired pneumonia, intestinal infections by Clostridium difficile, surgical site infections, and urinary tract infections associated with catheter use. HAIs represent one of the most frequent adverse events during healthcare delivery, resulting in prolonged hospital stays, long-term disability, resistance to antimicrobial resistance, or even increased unfavorable outcomes.

Extended emergency department (ED) stays with undiagnosed illnesses in an uncertain context of otherwise healthy and critically ill patients are likely to increase the risk of infections. Understanding the characteristics of patients who attend the ED and then develop HAIs during hospitalization is important.

The aim of this Special Issue is to address the characteristics of patients in the ED with particular reference to the diagnostic framework and management of cases that will develop an infection during hospitalization with particular reference to insight, control and prevention strategies.

Topics:

  • Which feaures of patients in the emergency department predict hospital-acquired infections following hospital admission?
  • Which ED patients are at particular risk for infection?
  • How to protect yourself and what strategies to adopt to prevent infections in the ED?
  • How to monitor at-risk cases?

Dr. Andrea Fabbri
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • healthcare-acquired infections
  • bloodstream infections
  • hospital‐acquired pneumonia
  • intestinal infections
  • clostridium difficile
  • surgical site infections
  • urinary tract infections
  • emergency department

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Published Papers (3 papers)

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Research

23 pages, 2670 KB  
Article
Prevalence and Multidrug Resistance of WHO-Priority Bacterial Pathogens in a Romanian Intensive Care Unit
by Alina Simona Bereanu, Bogdan Ioana Vintilă, Lilioara-Alexandra Oprinca-Muja, Rareș Bereanu, Ioana Roxana Codru, Raluca Maria Bădilă, Sandra Ioana Neamțu, Cosmin Ioan Mohor, Liiana Carmen Prodan and Mihai Sava
J. Clin. Med. 2026, 15(7), 2799; https://doi.org/10.3390/jcm15072799 - 7 Apr 2026
Viewed by 249
Abstract
Background/Objectives: The rise in healthcare-associated infections caused by multidrug-resistant (MDR) bacteria in hospitals, particularly in intensive care units, has resulted in increased rates of morbidity and mortality, escalating costs, and has become a significant public health concern. In our Intensive Care Unit, [...] Read more.
Background/Objectives: The rise in healthcare-associated infections caused by multidrug-resistant (MDR) bacteria in hospitals, particularly in intensive care units, has resulted in increased rates of morbidity and mortality, escalating costs, and has become a significant public health concern. In our Intensive Care Unit, we address healthcare-associated infections caused by multidrug-resistant bacteria, with a specific focus on those listed in the WHO 2024 List of Critically and Highly Prioritized Pathogens. Methods: Over the course of 1 year, from 1 January to 31 December 2024, we monitored the prevalence of healthcare-associated infections in the Intensive Care Unit of the Sibiu County Emergency Clinical Hospital, Romania, and the antibiotic susceptibility of the isolated bacteria. Results: The majority of infections were caused by pathogens in the ESKAPEE group. The most frequently isolated microorganism was Klebsiella pneumoniae (36.8%), followed by Acinetobacter baumannii (24.5%), classified as a critical priority by the WHO in 2024. Most positive samples for critical priority pathogens, including Klebsiella pneumoniae and Acinetobacter baumannii, as well as all MRSA strains (high priority), were obtained from tracheal aspirates collected from intubated and mechanically ventilated patients. A significant proportion of the isolated bacteria were multidrug-resistant, including extensively drug-resistant and pan-drug-resistant strains. Conclusions: The increase in antibiotic and antimicrobial resistance among hospital strains raises serious concerns about limited treatment options. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Insights, Prevention, and Control Strategies)
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16 pages, 1572 KB  
Article
Lessons from Two Early COVID-19 Hospital Outbreaks in Germany to Inform Strategies for Controlling Emerging Nosocomial Outbreaks of Highly Transmissible Respiratory Viruses
by Sofia Burdi, Felix Reichert, Barbara Mühlemann, Victor M. Corman, Terry C. Jones, Martin Hölzer, Susanne B. Schink, Patrick Larscheid, Jakob Schumacher, Gudrun Widders, Inas Abdelgawad, Christian Brandt, Nicole Dinsel, Katharina Jelavic, Nadine Kurzke, Jörg Hofmann, Janine Michel, Annika Brinkmann, Stephan Fuchs, Christian Drosten, Tim Eckmanns and Muna Abu Sinadd Show full author list remove Hide full author list
J. Clin. Med. 2026, 15(6), 2290; https://doi.org/10.3390/jcm15062290 - 17 Mar 2026
Viewed by 560
Abstract
Background/Objectives: Nosocomial outbreaks of viral respiratory infections strain healthcare systems and endanger patients and healthcare workers (HCWs). We describe two large nosocomial outbreaks with the SARS-CoV-2 Alpha variant, during its initial emergence in Germany, to assess transmission dynamics, effectiveness of control measures, [...] Read more.
Background/Objectives: Nosocomial outbreaks of viral respiratory infections strain healthcare systems and endanger patients and healthcare workers (HCWs). We describe two large nosocomial outbreaks with the SARS-CoV-2 Alpha variant, during its initial emergence in Germany, to assess transmission dynamics, effectiveness of control measures, and challenges in managing highly transmissible respiratory viruses. Methods: Confirmed cases were inpatients, HCWs, or their contacts testing SARS-CoV-2-positive since 1 January 2021 (Hospital A [HA])) or 21 January 2021 (Hospital B [HB])) with N501Y and delH69/V70 spike gene mutations. We conducted case interviews, reviewed medical records and shift schedules, and performed sequencing, genome reconstruction, and phylogenetic analysis. We describe cases, transmission chains, and control measures. Results: HA reported 18 patient cases, 20 HCW cases, and 33 community cases (N = 71). HB reported 48 patient cases, 43 HCW cases (13 in a COVID-19 ward), and 27 community cases (N = 118). In-hospital transmission occurred patient-to-patient, HCW-to-patient, patient-to-HCW, and HCW-to-HCW. HA halted admissions immediately after the initial cases; HB implemented measures gradually. Regular testing detected pre-symptomatic (HA = 6; HB = 18) and asymptomatic cases (HA = 3; HB = 13). Testing of agency staff was incomplete. The suspected primary case was an HCW in HA and a patient in HB who required resuscitation shortly after admission. Conclusions: Early COVID-19 outbreaks offer valuable lessons for managing emerging nosocomial outbreaks of highly transmissible respiratory viruses. Our findings provide empirical evidence for effective interventions, including rapid response, testing, HCW protection, and rigorous contact tracing in high-risk emergency situations. Managing agency staff remains a major challenge. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Insights, Prevention, and Control Strategies)
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12 pages, 943 KB  
Article
Healthcare-Associated Infections Impact Mortality in Patients Admitted to the Acute Care Hospital from the Emergency Department
by Andrea Fabbri, Ayca Begum Tascioglu, Flavio Bertini, Barbara Benazzi and Danilo Montesi
J. Clin. Med. 2026, 15(4), 1483; https://doi.org/10.3390/jcm15041483 - 13 Feb 2026
Viewed by 568
Abstract
Background/Objectives: Prolonged stays in overcrowded emergency departments (EDs) may contribute to an increased risk of healthcare-associated infections (HAIs) and therefore mortality. Early identification of the risk profile of these patients could reduce both complications and adverse outcomes. The study aimed to verify [...] Read more.
Background/Objectives: Prolonged stays in overcrowded emergency departments (EDs) may contribute to an increased risk of healthcare-associated infections (HAIs) and therefore mortality. Early identification of the risk profile of these patients could reduce both complications and adverse outcomes. The study aimed to verify whether the development of an HAI was associated with increased mortality. Design, settings and participants: This retrospective multicentre study involved all subjects who required urgent admission to an acute care hospital from the ED between 2023 and 2024. Outcome measures: A Cox proportional hazards model was used to test 30-day mortality. Results: Among the 20,234 patients considered for analysis, the mean age was 79 years (20) (median (IQR)), and a total of 1575 (7.8%) had died at 30 days. The main features selected for predicting mortality were in order of importance, diagnosis of neoplasm, older age, NEWS, diagnosis of infectious diseases, HAIs, diagnosis of respiratory diseases, CCI, priority level on arrival and male gender, yielding an accuracy of 0.804 ± 0.012. HAI occurrence was associated with a mortality risk ratio of 1.518 (95% confidence intervals (CI): 1.338–1.721; p < 0.001). The risk was higher for bloodstream infections (2.54; 2.12–3.06) and pneumonia (1.44; 1.20–1.73). Conclusions: The occurrence of HAIs was associated with an increased risk of mortality in patients admitted to acute care hospitals from the ED. This risk was particularly elevated in case of bloodstream infections and pneumonia. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Insights, Prevention, and Control Strategies)
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