Healthcare-associated infections in Romania: causes, consequences, and solutions

Healthcare-associated infections (HAIs) represent one of the most significant challenges for the Romanian healthcare system. According to the Point Prevalence Survey of Healthcare-Associated Infections conducted by the National Institute of Public Health in 2023, the prevalence of HAIs in Intensive Care units was 14.9% (Coman A., 2025), which means that 1 in 7 patients developed such an infection during their hospitalization. (National Center for Surveillance and Control of Diseases, 2024)

Causes of healthcare-associated infections

The etiology of HAIs is complex, involving structural, organizational, and behavioral factors. Major determinants include (Coman A., 2025):

• Non-compliance with international standards regarding hand hygiene (WHO) and improper application of disinfection protocols for surfaces and reusable medical devices.
• Low level of continuous staff training on HAI prevention and control, especially in units with high patient turnover.
• Staff shortages and overworked medical teams, which lead to decreased compliance with prevention procedures and increase the risk of breaches in infection control.

Consequences of inadequate practices in the prevention, control, and reporting of HAIs

Healthcare-associated infections not only increase morbidity and mortality but also have a direct impact on hospital resources (Coman A., 2025):

• Increased prevalence of multidrug-resistant (MDR/XDR) microorganisms, with a reduction in effective therapeutic options and the escalation of the use of last-resort antibiotics;
• Increased average length of hospital stay, with direct economic implications for healthcare units and indirect ones for patients and their families;
• Occurrence of severe postoperative complications, including readmissions, the need for additional procedures, or death;
• Under-reporting of HAI cases, caused by the lack of efficient digital surveillance mechanisms and the pressure perceived by medical staff regarding potential administrative consequences.

Effective strategies for reducing HAIs

Reducing the incidence of HAIs requires a complex, evidence-based intervention adapted to the risk level of each healthcare unit and supported by the national institutional framework. Priority measures include (Coman A., 2025):

• Implementation and strict, continuous monitoring of hygiene and disinfection protocols, differentiated by risk categories and functional zones;
• Use of approved disinfectants with a broad spectrum and demonstrated efficacy against MDR/XDR germs, in accordance with EN standards and national regulations;
• Periodic training of medical and auxiliary staff through courses, simulations, and assessments regarding adherence to prevention measures;
• Modernization of hospital infrastructure and digitization of reporting and epidemiological surveillance processes, for a rapid response based on real-time data.

Klintensiv's contribution to HAI control in medical facilities

Klintensiv supports healthcare units in Romania in their efforts to prevent and control hospital-acquired infections through an integrated package of solutions:

• Provision of approved disinfectants, with documented effectiveness against clinically relevant pathogens and proven stability in use;
• Specialized training for medical and cleaning staff, focused on essential measures in HAI prevention, adapted to the specific needs of each department;
• Facilitating a safe clinical environment for patients and staff, through the application of measures and products tailored to the particularities of each medical institution.

Reducing the incidence of HAIs is not only a strategic priority but also a critical necessity for the Romanian healthcare system. Preventing these infections is not just a legal obligation, but an essential indicator of the quality of medical care and professional responsibility. Implementing integrated, sustainable, and scientifically validated solutions is crucial for ensuring patient safety and strengthening trust in the healthcare system.

Bibliography

National Center for Surveillance and Control of Diseases. (2024). Point Prevalence Survey of Healthcare-Associated Infections and antimicrobial consumption in hospitals in Romania - 2023. NIPH.

Coman A., P. D. (2025, 01 24). Surveillance and Reporting of Hospital-Associated Infections—A Document Analysis of Romanian Healthcare Legislation Evolution over 20 Years. Healthcare (Basel), 13(3). doi:10.3390