Six-year trends in health care-associated infections in Chilean hospitals: A national surveillance analysis (2017-2022).

BACKGROUND

Health care-associated infections (HAIs) remain a major patient safety challenge in hospital settings. Surveillance systems provide monitoring, but few studies integrate long-term trends in infection risk and outcomes with measures of system capacity and emergency investment.

METHODS

We conducted a descriptive analysis of national HAI surveillance data from Chilean public hospitals spanning 2017 to 2022, reported in accordance with STROBE guidelines. Indicators included HAI prevalence, device utilization ratios, incidence densities for ventilator-associated pneumonia (VAP), central-line-associated bloodstream infection, catheter-associated urinary tract infection, VAP case fatality rates, and outbreak reports. Emergency health investment data were integrated to explore temporal patterns before, during, and after the COVID-19 pandemic.

RESULTS

HAI prevalence remained stable over 6 years. However, device utilization increased during 2020 to 2021, with corresponding rises in device-associated infection rates, particularly VAP. VAP case fatality rates increased in 2020 to 2021, reversing pre-pandemic declines. Periods of rapid expansion in critical care capacity coincided with higher outbreak reports.

CONCLUSIONS

During the COVID-19 pandemic, device-associated infections and infection-related severity increased despite stable HAI prevalence. By linking surveillance data with indicators of system capacity and emergency investment, this study helps explain how large-scale system disruptions affect infection risk and patient outcomes. Strengthening infection prevention alongside surge planning remains essential.