Historical and changing epidemiology of healthcare-associated infections.

This review compares the historical perspectives on healthcare-associated infections (HCAIs) with the current changing epidemiological picture as it relates to these infections. Evidence in support of these changes is given using trends in mortality for Clostridium difficile and meticillin-resistant Staphylococcus aureus bacteraemia in England as examples. The impact of current intervention programmes which target these, and other HCAIs, is also considered and knowledge gaps and options for changes in public health strategy required to achieve further reductions in HCAIs in the National Health Service in England are identified.