Healthcare associated infections-the size of the problem

Abstract

The global burden of healthcare associated infections (HAI) is currently unknown, despite international efforts to fill this gap in our knowledge. Where the size of the burden of HAI has been quantified, the greatest impact is in those countries with least resources to measure and manage them. Across industrialised nations where surveillance systems exist, the challenges are of targeting resources, achieving harmonised definitions of HAI, choosing which processes and outcomes should be measured, and either within the healthcare setting or to external scrutiny. HAI have additionally come into use as performance indicators, promoted as part of the patient safety agenda, and, together with the arrival of a 'zero tolerance' approach for preventable HAI, these have led in some centres to financial sanctions for failure to prevent. The consequences of these developments remain to be determined.