Advances in the Surveillance and Prevention of Healthcare-Associated Infections

A special issue of Pathogens (ISSN 2076-0817).

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 5987

Special Issue Editor


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Guest Editor
School of Medicine, University of California, San Diego, CA 92093, USA
Interests: hepatitis C infection; hepatitis B infection; HIV; healthcare associated infections; infectious diseases

Special Issue Information

Dear Colleagues,

Healthcare-associated infections (HAIs) are infections that patients experience while or after receiving medical care. HAIs are recognized as a global health concern contributing to morbidity and mortality, and are associated with readmission to the hospital, extended length of stay and increased costs. Standardized surveillance and public reporting of healthcare-associated infections are an integral part of infection control programs in most countries. These programs ensure also that feedback is provided to the clinical teams comparing risk-adjusted HAI outcomes to similar institutions across the nation to develop action plans for process improvement, and to verify the effectiveness of the prevention measures introduced.

Over the past 20 years, safety and quality improvement programs have used HAI surveillance to achieve better outcomes. Studies have demonstrated that a significant proportion of healthcare-associated infections and conditions can be prevented using simple and continuous performance improvement strategies, such as Plan–Do–Study–Act (PDSA) cycles. As surveillance methodologies, risk assessments and prevention initiatives become more sophisticated and complex, additional efforts are needed to increase our knowledge in this field.

This Special Issue aims to provide the latest questions and controversies surrounding the surveillance, prevention, and control of HAIs. We invite experts worldwide to submit research articles or review articles related to this important topic. Suggested topics include but are not limited to the following:

  • Hospital-onset bacteremia or fungemia vs. central line-associated bloodstream infection surveillance;
  • Changing hospital-onset C. difficile surveillance from LABID to alternative options;
  • Are transmission-based precautions for high-frequency MDROs (e.g. MRSA) still indicated?;
  • Updating SARS-CoV-2 and other respiratory viral pathogen transmission precautions;
  • Hospital value-based purchasing in sepsis care;
  • Diagnostic stewardship of UTIs.
  • Tuberculosis screening and mask fit-testing in healthcare workers.
  • Innovations in antimicrobial stewardship.
  • Adopting sustainable stewardship measures to reduce medical waste in healthcare.
  • Prevention of medical device contamination from environmental microorganisms.

Prof. Dr. Francesca J. Torriani
Guest Editor

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Keywords

  • healthcare-associated infections (HAIs)
  • nosocomial infections
  • HAI-associated pathogens
  • infection prevention and control
  • antimicrobial resistance and antimicrobial stewardship

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Published Papers (4 papers)

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18 pages, 3842 KB  
Article
Impact of a UV-C Multiemitter Disinfection System on Hospital Environmental Bioburden and Inactivation of Clinically Relevant Pathogens
by Edgar Fiscal-Baxin, Auria del Carmen López-Hernández, María Fernanda González-Ruiz, Gabriel Carrisoza-Martínez, Adriana Lisbeth Lopez-Avila, Daniela Moreno-Torres, Adolfo López-Ornelas, Clemente Cruz-Cruz, Emilio Mariano Durán-Manuel, Miguel Ángel Loyola-Cruz, Magnolia del Carmen Ramírez-Hernández, Gustavo Esteban Lugo-Zamudio, Oscar Sosa-Hernández, Luis Gustavo Zárate-Sánchez, Paulina Carpinteyro-Espin, Rocio Flores-Paz, Dulce M. Razo Blanco-Hernández, Alicia Jiménez-Alberto, Juan A. Castelán-Vega, Claudia C. Calzada-Mendoza and Juan Manuel Bello-Lópezadd Show full author list remove Hide full author list
Pathogens 2026, 15(3), 246; https://doi.org/10.3390/pathogens15030246 - 25 Feb 2026
Viewed by 957
Abstract
Healthcare-associated infections remain a central hospital challenge, particularly in critical areas where invasive procedures and microbial contamination overlap. The hospital environment, including air and high-touch surfaces, acts as a persistent microorganism source that favors stability and spread. UV-C disinfection systems have become complementary [...] Read more.
Healthcare-associated infections remain a central hospital challenge, particularly in critical areas where invasive procedures and microbial contamination overlap. The hospital environment, including air and high-touch surfaces, acts as a persistent microorganism source that favors stability and spread. UV-C disinfection systems have become complementary tools to conventional cleaning. This study evaluated the disinfectant efficacy of a 254 nm multiemitter UV-C system under in situ and in vitro conditions. A 254 nm UV-C multiemitter system was deployed to eight hospital areas selected for epidemiological relevance. Air and surface sampling were conducted before and after standardized UV-C cycles. The bacterial and fungal aerobiome was quantified (CFU/m3) and surfaces were characterized by MALDI-TOF mass spectrometry. In vitro assays tested efficacy against planktonic cultures and mature biofilms of clinical ESKAPE isolates and C. albicans. The UV-C intervention achieved mean aerobiome reductions above 91.5%, with complete elimination in multiple critical zones. Surface contamination was reduced by 96.1%, including total disinfection across several sampled points. In vitro testing showed ≥99.99% to 100% elimination of planktonic microorganisms. Mature biofilms exhibited full loss of viability after UV-C exposure, independent of biofilm architecture and structural complexity. Therefore, the 254 nm UV-C multiemitter system significantly reduced environmental microbial burden in critical hospital areas, supporting its integration within infection-prevention programs and reinforcing environmental biosafety through the control of the microbial sources involved in transmission dynamics. Full article
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15 pages, 2715 KB  
Article
Optimizing Textile Disinfection in Hospital-Associated Infections Using Gaseous Ozone
by Francesco De Caro, Federica Dell’Annunziata, Oriana Motta, Nicoletta Capuano, Antonio Faggiano, Leonardo Aulisio, Matteo Tomeo, Emanuela Santoro, Giovanni Boccia, Mario Capunzo, Giuseppina Moccia, Veronica Folliero and Gianluigi Franci
Pathogens 2025, 14(10), 977; https://doi.org/10.3390/pathogens14100977 - 26 Sep 2025
Cited by 1 | Viewed by 2280 | Correction
Abstract
Healthcare-associated infections (HAIs) pose a significant risk in clinical settings by extending hospitalization times and increasing healthcare costs. This study aimed to evaluate the effectiveness of gaseous ozone, generated by an automatic rotary dispenser, in disinfecting hospital fabrics contaminated with common HAI-related pathogens. [...] Read more.
Healthcare-associated infections (HAIs) pose a significant risk in clinical settings by extending hospitalization times and increasing healthcare costs. This study aimed to evaluate the effectiveness of gaseous ozone, generated by an automatic rotary dispenser, in disinfecting hospital fabrics contaminated with common HAI-related pathogens. The antimicrobial efficacy of ozone was tested on cotton, polyester, and blended fabrics artificially contaminated with Staphylococcus aureus, Escherichia coli, and Candida albicans. The fabrics were exposed to ozone treatment cycles of 25 and 45 min. Additional tests were conducted on layered fabrics to assess ozone penetration into folds and seams. A 25 min ozone exposure significantly reduced the microbial load on all tested fabrics. A 45 min cycle resulted in an almost complete elimination of the tested pathogens. Ozone also effectively disinfected inner fabric layers, indicating its ability to reach areas typically resistant to conventional cleaning methods. Gaseous ozone demonstrates high efficacy as a disinfectant for hospital textiles, offering thorough decontamination across various materials and fabric structures. This technology represents a sustainable, residue-free alternative to traditional disinfection methods and promises to reduce the transmission of HAIs in healthcare environments. Full article
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10 pages, 497 KB  
Article
Impact of Multifaceted Interventions Including Waterless Patient Care on Endemic Occurrence of Serratia marcescens in an Intensive Care Unit
by Romain Martischang, Gaud Catho, Abdessalam Cherkaoui, Filippo Boroli, Niccolo Buetti, Jerome Pugin and Stephan Harbarth
Pathogens 2025, 14(4), 363; https://doi.org/10.3390/pathogens14040363 - 8 Apr 2025
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Abstract
Serratia marcescens acquisition is a common problem in intensive care units (ICUs). Following an initial outbreak in 2017 with ongoing endemicity, this study aimed to analyze the impact of behavioral interventions and sink removals on S. marcescens incidence in a tertiary-care ICU. We [...] Read more.
Serratia marcescens acquisition is a common problem in intensive care units (ICUs). Following an initial outbreak in 2017 with ongoing endemicity, this study aimed to analyze the impact of behavioral interventions and sink removals on S. marcescens incidence in a tertiary-care ICU. We conducted a quasi-experimental, interventional study including patients with a positive screening or clinical culture for S. marcescens, from 48 h (D2) after ICU admission to 14 days after ICU discharge. A sub-analysis considered patients positive for S. marcescens from ICU admission (D0) to 14 days after ICU discharge. Multivariate Poisson regression analyses were performed. Between January 2014 and December 2022, 167 cases of S. marcescens infection or colonization were identified (respiratory samples, 71%). Despite the presence of an aquatic reservoir, we found that neither behavioral nor architectural interventions (sink removal) reduced significantly S. marcescens incidence, yielding incidence ratios of 1.02 [95%CI 0.33–3.11] and 4.25 [95%CI 0.59–30.56], respectively. However, an association was observed with administration of selective oral decontamination (SOD) in the sub-cohort (OR 1.01; 95%CI 1.00–1.03). Behavioral change interventions and transition to a waterless ICU did not control endemic, polyclonal S. marcescens occurrence. The selective pressure exercised by SOD may have reduced the effectiveness of waterless care. Full article
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3 pages, 1388 KB  
Correction
Correction: De Caro et al. Optimizing Textile Disinfection in Hospital-Associated Infections Using Gaseous Ozone. Pathogens 2025, 14, 977
by Francesco De Caro, Federica Dell’Annunziata, Oriana Motta, Nicoletta Capuano, Antonio Faggiano, Leonardo Aulisio, Matteo Tomeo, Emanuela Santoro, Giovanni Boccia, Mario Capunzo, Giuseppina Moccia, Veronica Folliero and Gianluigi Franci
Pathogens 2026, 15(3), 252; https://doi.org/10.3390/pathogens15030252 - 27 Feb 2026
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Abstract
In the original publication [...] Full article
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