Hospital-Acquired Infections in the Era of Antimicrobial Resistance: From Infection Prevention to Precision Infection Control

Abstract

The problem of Hospital-Acquired Infections (HAIs) is a major issue in contemporary health care systems, especially with the speed at which antimicrobial resistance (AMR) is developing. The emergence of multidrug-resistant (MDR) pathogens has made it more difficult to treat and use standard antimicrobials, resulting in longer hospital stays, more expensive health care, and increased mortality. Resistant organisms like methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii are frequently associated with major HAIs, including catheter-associated urinary tract infections, central line-associated bloodstream infections, ventilator-associated pneumonia, surgical site infections, and Clostridioides difficile infections. To manage HAIs effectively, a multifaceted strategy involving antimicrobial stewardship programs, advanced surveillance techniques and infection prevention measures is essential. Innovative methodologies such as rapid molecular diagnostics, whole genome sequencing, AI, digital healthcare platform and personalised antimicrobial therapy have been introduced as recent developments in precision infection control. These technologies allow for predicting resistance, early detection of pathogens, outbreak detection and targeted therapeutic interventions. In addition, novel antimicrobial strategies such as bacteriophage therapy, antimicrobial peptides, monoclonal antibodies, microbiome-based strategies and nanotechnology-enabled drug delivery systems offer promising opportunities for combating resistance. But these developments come with challenges, including low rates of antibiotic discovery, global disparities in health care resources, a lack of precision approaches and validation problems in the clinic. This review identifies the present burden of HAIs during the AMR era, discusses major strategies for infection prevention and antimicrobial stewardship, and explores the role of precision infection control technologies in patient safety.  Combined with the application of AI, smart healthcare systems and One Health approaches, future work that integrates genomic surveillance could offer sustainable solutions for controlling HAIs and minimizing the global impact of antimicrobial resistance.