Hospital-associated or healthcare-associated infections (HAIs) are infections that occur during or after a patient’s stay in a healthcare facility. In addition to representing a problem relating to the state of health of people, infections weigh on the National Health System – and at the European level – with a quantifiable burden in terms of costs; an economic aspect that should not be underestimated.

We at AMIL Care think it is essential to reflect on the issue. For this reason, we have decided to dedicate an article to you, designed to assist the work of professionals such as purchasing managers in hospitals, medical equipment management managers, clinical engineers, safety, and hygiene managers (HSE), those responsible for clinical risk management.

The number of healthcare-associated infections

Healthcare-associated infections are one of the most frequent complications in hospital care, with both clinical and economic impacts. 

These complications, widespread and often underestimated involve considerable clinical and economic costs, causing a lengthening of the patient’s hospitalization times and imposing a heavy commitment of resources and personnel. 

This intense consumption of healthcare resources not only burdens the hospital system but also affects the pockets of patients and their families. The picture is further complicated when one considers the long-term consequences of such infections, which can lead to disability and, in some cases, fuel the resistance of microorganisms to antibiotics. 

Therefore, it is not only a question of quality of life for patients, but also an economic problem that weighs on the budgets of health systems 

Hospital infections, with their chain of negative repercussions, outline a complex landscape in which clinical, economic, and social challenges are intertwined and not easily solvable. 

Several studies, including the one conducted by Economic Evaluation and EHTA of the CEIS and financed by the Ministry of Health, report a portrait of the situation in Italy. 

In Europe, 8.9 million cases of healthcare-associated infections have been identified per year, resulting in 16 million additional days of hospitalization, with an estimated €7 billion in direct costs alone. While in our country, the numbers are different.

The Ministry of Health reports that in Italy between 450,000 and 700,000 hospital infections are recorded annually, this means that a healthcare-related infection occurs in 4-7% of hospitalizations. To come to an estimate of average annual costs, just consider that a single infection is equivalent to spending between 5,000 and 10,500 euros. It should be considered that an HAI usually implies a two-and-a-half times longer hospital stay for the patient, and consequently at least triple hospitalization costs. In addition, some infections are more expensive than others to treat, such as those from surgical wounds and blood. 

An additional element to consider when analyzing the picture of healthcare-related infections is the upward trend of hospitalizations between 2006 and 2018. Although there was a reduction in acute care hospitalizations in ordinary care during this period, it was accompanied by an increase in highly antibiotic-resistant microorganisms, particularly Gram-negative bacteria. 

The reduction of HAI remains an objective to be actively pursued, being already present in the National Antibiotic Resistance Fight Plan of the Ministry of Health in 2017. 

The most common causes of HAIs and how they are transmitted

When we talk about healthcare-related infections, we consider both exogenous infections, i.e. transmitted from the outside, for example through operators or the environment, and endogenous infections, caused by bacteria present inside the body. Patients are most affected, but healthcare personnel and visitors can also be exposed. 

The most common healthcare-related infections concern those of the urinary tract (which alone account for 35-40% of hospital infections), respiratory tract, surgical wounds, and blood (sepsis and bacteremia). 

The triggers of these infections can be different, including: 

  • surgical operations
  • weakened immune system
  • excessive use of antibiotics
  • insufficient environmental hygiene measures
  • inefficient prevention protocols

How are HAIs transmitted? There are many ways of transmission, ranging from direct person-to-person contact, even through the air (such as droplets emitted by talking, sneezing, and coughing), to that with health professionals, and finally, to indirect contact through contaminated objects, including common surfaces. Considering this information, it is evident that adequate disinfection and sanitization of environments is a fundamental element in the fight against the transmission of healthcare-related infections. 

Can healthcare-associated infections be prevented?

It must be said that not all HAIs are preventable, despite this, it has been possible to estimate that more than 50% of healthcare-associated infections can be prevented. 

This can be done through correct prevention practices and by following dedicated protocols, which could lead to their reduction, as well as reducing the economic costs of hospital infections. 


Good prevention of healthcare-related infections certainly starts from the basics, i.e. correct handwashing, which remains one of the most important practices for reducing the risk of transmitting and/or contracting infections.

This gesture of fundamental importance is associated with further necessary precautions, such as the correct use of antibiotics and disinfectants, the reduction of unnecessary diagnostic and therapeutic procedures, the sterilization of devices, the control of the risk of environmental infection, and advanced sanitization of environments.

To ensure uniform national guidelines on hospital infections in Italy, two circulars from the Ministry of Health were published in the past (52/1985 and 8/1988). These circulars recommended the establishment of regional control programs, the launch of a hospital infection control program in hospitals with the establishment of a control committee, and the definition of surveillance methods to be adopted. 

The 1998-2000 National Health Plan had also already included the prevention of hospital infections among the main objectives. An objective that was taken up again in the 2002-2004 National Health Plan and which, as we have seen, continues to remain extremely topical: the challenge to the HAIs is both a present and a future challenge. 

The role of AMIL Care in the fight against healthcare-associated infections

AMIL Care systems and products are a valuable and extremely important aid in the fight against healthcare-associated infections and their impact, which continues to be considerable. 

The Medisystem system, which combines automated dispensing devices with chemical disinfectant products, is patented and certified, thus guaranteeing a standardized protocol, regardless of human intervention – and the consequent possibility of error.

A solid and reliable solution for sanitizing hospital environments and assistance activities.

The Medisystem system consists of Medibios, an automated dispensing device, and Evolyse, a hydrogen peroxide, and silver sulfate-based disinfectant, available in two concentrations (6% and 12%). 

In particular, Medibios plus and Medibios plus hub meet the needs of hospital and care environments and, due to their advanced features, they are perfectly suited to the stringent standards required 

In fact, for example, with Medibios plus and Medibios plus. hub it is possible to store various data, such as the number of programs used, duration, day of execution, room temperature, and start and end time of the cycle, thus creating reports that can be saved. 

AMIL Care’s role is not limited to that of a manufacturing company but goes further and includes acting, thanks to its experience, as an educator of all those processes that revolve around the themes of disinfection and sanitization.

That is why AMIL Care cannot avoid confronting what the current reality poses, such as in this case, the impact on the healthcare sector and the lives of many people of healthcare-related infections.

In this sense, it is committed to continuous research, updating, and attentive listening to problems to find suitable solutions.