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The future of healthcare-associated infection surveillance: Automated surveillance and using the potential of artificial intelligence
Karolinska Institutet, Stockholm, Sweden.
National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Stockholm University, Faculty of Social Sciences, Department of Computer and Systems Sciences.ORCID iD: 0000-0001-9731-1048
Charité—Universitätsmedizin Berlin, Berlin,Germany.
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Number of Authors: 72025 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 298, no 2, p. 54-77Article in journal (Refereed) Published
Abstract [en]

Healthcare-associated infections (HAI) are common adverse events and surveillance is considered a core component of effective HAI reduction programs. Recently, efforts have focused on automating the traditional manual surveillance process by utilizing data from electronic health record (EHR) systems. Using EHR data for automated surveillance, algorithms have been developed to identify patients with ventilator-associated pneumonia and bloodstream, surgical site infections, urinary tract, and Clostridioides difficile infections (sensitivity 54.2%–100%, specificity 63.5%–100%). Methods based on natural language processing have been applied to extract information from unstructured clinical information. Further developments in artificial intelligence (AI), such as large language models, are expected to support and improve a variety of aspects within the surveillance process; for example, more precise identification of patients with HAI. However, AI-based methods have been applied less frequently in automated surveillance and more frequently for early prediction, particularly for sepsis. Despite heterogeneity in settings, populations, sepsis definitions, and model designs, AI models have shown promising results, with moderate to very good performance (accuracy 61–99%) and predicted sepsis within 0–40 hours before onset. AI-based prediction models that can detect patients at risk of developing different HAI should be explored further. The continuous evolution of AI and automation will transform HAI surveillance and prediction, offering more objective and timely infection rates and predictions. The implementation of AI-supported automated surveillance and prediction systems for HAI in daily practice remains scarce. The successful development and implementation of these systems demand requirements related to technical capabilities, governance, practical and regulatory considerations, and quality monitoring.

Place, publisher, year, edition, pages
2025. Vol. 298, no 2, p. 54-77
Keywords [en]
artificial intelligence, automated surveillance, early prediction, healthcare-associated infections, sepsis
National Category
Natural Language Processing
Research subject
Computer and Systems Sciences
Identifiers
URN: urn:nbn:se:su:diva-247397DOI: 10.1111/joim.20100ISI: 001502822600001PubMedID: 40469046Scopus ID: 2-s2.0-105007237006OAI: oai:DiVA.org:su-247397DiVA, id: diva2:2000583
Available from: 2025-09-24 Created: 2025-09-24 Last updated: 2025-09-24Bibliographically approved

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