Effectiveness analysis of enhanced active surveillance for healthcare-associated infections

Healthcare-associated infections (HAIs) are a major public health concern. Active surveillance of HAI cases with timely feedback on infection prevention and control (IPC) measures is a core component of IPC programs. This study aims to evaluate the effectiveness of enhanced active surveillance for healthcare-associated infections. This retrospective study was conducted at a tertiary hospital in China. The study period was divided into two phases: a pre-intervention period (Period 1) from 2018 to 2022 and a post-intervention period (Period 2) from 2023 to 2025. During the intervention period, enhanced active surveillance was implemented, in which a multidisciplinary IPC team conducted daily active surveillance utilizing a novel intelligent early warning system and provided real-time feedback on infection diagnosis, antimicrobial use, isolation practices, and environmental hygiene. A total of 2,600 HAI cases were identified in Period 1 and 1,697 in Period 2. The delayed reporting rate decreased significantly from 32.85% to 28.23% ( p = 0.001), with an average quarterly decline of 1.240% (95% CI: −2.408% to − 0.078%) during Period 2 ( p = 0.033). The pre-discharge reporting rate increased significantly from 74.54% to 89.69% ( p < 0.001), with an immediate increase of 13.453% (95% CI: 3.143% to 23.763%) at the intervention point ( p = 0.012). The median time of delayed reporting decreased from 11 days (IQR: 7–18) to 8 days (IQR: 6–12) ( p < 0.001). The median time from infection onset to discharge decreased from 11 days (IQR: 6–21) to 9 days (IQR: 5–17) ( p < 0.001), and the median time from reporting to discharge decreased from 9 days (IQR: 4–19) to 7 days (IQR: 4–14) ( p < 0.001). Enhanced active surveillance for HAIs, combining an intelligent early warning system with a dedicated multidisciplinary IPC team, improved the timeliness of case reporting, increased the pre-discharge reporting rate, and was associated with shortened time from infection onset to discharge and from reporting to discharge.