Healthcare-Associated Infections: Emerging Challenges, Antimicrobial Resistance, and Strategies for Effective Infection Prevention and Control

Healthcare-associated infections (HAIs) are an important cause of preventable morbidity and mortality and remain a major challenge to patient safety and healthcare quality. These infections can develop during healthcare delivery and are associated with prolonged hospitalization, increased treatment costs, and additional pressure on healthcare resources. The burden is particularly significant in low- and middle-income countries, where limitations in infection prevention infrastructure, surveillance, trained personnel, and water, sanitation and hygiene services may increase the risk of transmission. The emergence and spread of antimicrobial-resistant (AMR) microorganisms further complicate the prevention and treatment of HAIs. This narrative review summarizes the major types of HAIs, commonly associated microorganisms, risk factors, antimicrobial resistance, diagnostic approaches, and surveillance practices. It also discusses essential infection prevention and control (IPC) measures, including hand hygiene, appropriate use of personal protective equipment, environmental cleaning, sterilization and disinfection, safe healthcare practices, isolation precautions, and antimicrobial stewardship. Particular attention is given to challenges in implementing effective HAI prevention and surveillance in India. Strengthening evidence-based IPC programmes, microbiological surveillance, healthcare-worker training, rational antimicrobial use, and institutional commitment is essential for reducing the burden of HAIs. An integrated approach combining infection prevention, early diagnosis, surveillance, and antimicrobial stewardship can contribute to safer healthcare delivery and help limit the spread of antimicrobial resistance. Keywords Healthcare-associated infections; Infection prevention and control; Antimicrobial resistance; Hospital-acquired infections; Infection surveillance; Antimicrobial stewardship; Patient safety