Dear Colleagues,

Healthcare-associated infections (HAIs) are a growing global health concern. According to WHO definition, HAIs (also referred to as nosocomial or hospital infections) are infections occurring in a patient during the process of care in a hospital or other healthcare facility that were not present or incubating at the time of admission.

Up to 15% of all hospitalized patients in acute care settings acquire one or more HAIs as a direct consequence of hospitalization in the western world, and the rate is even higher in low-income countries and, in particular, wards, including pediatric and intensive care units.

Over 3 million patients in the EU and 2 million patients in the USA are estimated to acquire a HAI each year. Approximately 37,000 patients die every year in EU and 90,000 in the USA as a direct consequence of HAI, ranking HAIs as the fifth leading cause of death in US hospitals.

The substantial impairment of patient outcome and the financial burden of HAIs is staggering.

The overall direct costs associated with HAI management are over 1 billion Euro in Europe and up to 45 billion US$. However, most HAIs are thought to be preventable, and their prevention and control depend on multiple factors, including the adoption of standard and transmission-based precautions, appropriate environmental hygiene, pertinent diagnostics, and prudent antibiotic use. Concern about HAIs is in accompanied and worsened by concern about anti-microbial resistance (AMR), as most HAI-associated pathogens are drug-resistant and cause infections that are difficult to treat. Particularly in the hospital environment, due to the selective pressure exerted by the widespread use of antibiotics, in recent decades HAI-associated pathogens have been observed to be increasingly resistant to drugs; thus, HAIs tend to exhibit higher resistance rates to antibiotics compared with community-acquired infections, further threatening the outcome of infections in hospitalized patients. Consequently, AMR in HAIs is a recognized threat to global public health. However, although HAIs represent the most frequent adverse event in health care, their true global burden is still unclear, due to the difficulty in obtaining reliable data and the lack of uniformity of diagnostic criteria.

Studies in the past years have described HAI epidemiology and prevalence, trying to define the risk factors as well as the factor bundle associated with the prevention and control of HAIs. However, further effort is needed to increase our knowledge of HAI transmission routes and HAI-associated agents evolution and circulation between different healthcare facilities, as well as in identifying local determinants of the HAI burden; implementing hygiene precautions, staff education, and accountability; and conducting research to validate surveillance.

For this Special Issue of Pathogens, we invite you to submit research articles, review articles, short notes, as well as communications related to all aspects concerning HAI research and management. We look forward to your contribution.

Prof. Elisabetta Caselli
Dr. Luca Arnoldo
Guest Editor

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• healthcare-associated infections
• epidemiology
• diagnostics
• antimicrobial resistance
• HAI-associated pathogens
• antimicrobial therapy
• pathogenicity factors
• risk assessment
• infection prevention and control strategies