Child in hospital bed surrounded by glowing orbs representing HAI surveillance methods

Hospital Infections in Kids: Which Surveillance Method Wins?

Theo Raines in Health & Wellness December 2025 • 3 min read.

"Uncover the most effective ways to track and prevent healthcare-associated infections (HAIs) in children's hospitals, ensuring a safer environment for our youngest patients."

Healthcare-associated infections (HAIs) are a significant concern in hospitals worldwide, leading to adverse outcomes and increased costs. Children, with their developing immune systems, are particularly vulnerable. Effective surveillance is crucial for identifying and controlling these infections, but the best approach can vary depending on available resources and the specific healthcare setting.

In 2012, South Africa mandated HAI surveillance but didn't specify the methods. This study, conducted at Tygerberg Children's Hospital, compares three surveillance methods – point prevalence surveys (PPSs), laboratory surveillance, and antimicrobial prescription tracking – against a prospective clinical surveillance method to determine which performs best in a resource-limited setting.

The goal is to guide healthcare facilities in selecting the most suitable HAI surveillance strategy, balancing accuracy with feasibility to improve patient safety and reduce the burden of infection.

Decoding HAI Surveillance Methods: Which One Works Best?

Child in hospital bed surrounded by glowing orbs representing HAI surveillance methods

The study evaluated three main HAI surveillance methods and they are described below:

Prospective Clinical Surveillance: Considered the 'gold standard,' this method involves continuous monitoring of patients for HAI symptoms and laboratory confirmation.

Point Prevalence Surveys (PPSs): Conducting surveys at specific points in time to determine the proportion of patients with HAIs.
Laboratory Surveillance: Tracking infections based on laboratory results, such as blood cultures and urine tests.
Antimicrobial Prescription Tracking: Monitoring the use of antibiotics to identify potential HAIs.

The study found that combining laboratory surveillance with antimicrobial prescription tracking offered the best balance of sensitivity and accuracy. While PPSs are easy to implement, they may miss many infections. Relying solely on laboratory data may also be misleading because it may be hard to distinguish infections acquired from community or hospital.

Takeaways: Customizing Your HAI Surveillance Strategy

The research highlights that no single HAI surveillance method is universally superior. Healthcare facilities must consider their unique resources, patient populations, and infection control priorities.

For resource-limited settings, combining laboratory surveillance with antimicrobial prescription tracking offers a practical and effective approach. Regular PPSs can supplement these methods to provide a broader view of HAI prevalence.

Ultimately, the most successful HAI surveillance strategy is one that is tailored to the specific context of the healthcare facility, continuously monitored and adapted to improve its effectiveness over time, ultimately protecting the most vulnerable patient populations.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.7196/samj.2017.v107i1.11431, Alternate LINK

Title: Surveillance Of Healthcare-Associated Infection In Hospitalised South African Children: Which Method Performs Best?

Subject: General Medicine

Journal: South African Medical Journal

Publisher: South African Medical Association NPC

Authors: A Dramowski, M F Cotton, A Whitelaw

Published: 2016-12-21

Everything You Need To Know

Why are healthcare-associated infections a particular concern in children's hospitals?

Healthcare-associated infections, or HAIs, pose a significant threat, especially to children due to their developing immune systems. Effective surveillance is paramount to control these infections within hospitals. Selecting the right surveillance method is a balancing act, considering both accuracy and the practical limitations of the healthcare setting to safeguard patients.

What makes prospective clinical surveillance the 'gold standard' for HAI detection, and what are its limitations?

Prospective clinical surveillance is often regarded as the 'gold standard' because it involves continuous, real-time monitoring of patients for any signs of HAIs. This method also incorporates laboratory confirmations to ensure accuracy. However, its resource-intensive nature may make it challenging to implement in settings with limited resources.

What are point prevalence surveys (PPSs), and what are their limitations in detecting HAIs?

Point prevalence surveys involve conducting periodic snapshots to determine the proportion of patients with HAIs at specific times. While PPSs are relatively easy to implement, they may miss a significant number of infections that develop between survey periods. This can lead to an underestimation of the true burden of HAIs.

How does laboratory surveillance work in detecting HAIs, and what are its potential drawbacks?

Laboratory surveillance focuses on tracking infections based on laboratory results, such as blood cultures and urine tests. While this method can be effective, it may be difficult to distinguish between infections acquired within the hospital versus those acquired in the community. Additionally, relying solely on laboratory data may overlook clinically relevant infections that are not confirmed by lab tests.

How does antimicrobial prescription tracking aid in HAI surveillance, and what are its advantages when combined with other methods?

Antimicrobial prescription tracking involves monitoring the usage of antibiotics within the hospital. This can help identify potential HAIs, as increased antibiotic use may indicate a higher prevalence of infections. When combined with laboratory surveillance, antimicrobial prescription tracking can offer a more balanced and accurate approach to HAI surveillance.