The Ministry of Health and Food Safety, through the Department of Health Services’ Nursing and Social Security Division, has issued the Healthcare Associated Infections Surveillance Standard Operating Procedure, approved through a ministerial-level decision in November 2025. The SOP is intended for public and private healthcare facilities at national and subnational levels and aims to standardize how hospitals identify, record, analyze and report infections acquired during healthcare. It focuses particularly on bloodstream infections (BSI/CLABSI), urinary tract infections (UTI/CAUTI), surgical site infections (SSI), hospital-acquired pneumonia (HAP/VAP) and multidrug-resistant organisms.

The document recommends an active, patient-based, prospective and priority-directed surveillance model, using standardized clinical, laboratory and radiological criteria. In most cases, an infection must develop at least 48 hours after admission or the start of care to qualify as healthcare-associated, while surgical-site infections are monitored for 30 days after surgery. Hospitals are instructed to collect daily patient and device data, calculate infection incidence using patient-days and device-days, track central-line, catheter and ventilator utilization, and assess pathogens for antimicrobial resistance, including MRSA, VRE, carbapenem-resistant organisms and other MDR/XDR bacteria.

The SOP creates a structured reporting chain from hospital wards to national authorities. Health facilities must establish dedicated surveillance teams involving IPC personnel, clinicians, nurses, laboratory staff, medical recorders and data managers; compile and analyze data monthly; and report prescribed indicators to the Nursing and Social Security Division. The document includes standardized trigger forms, denominator records, infection-specific reporting forms, a national reporting template, outbreak-investigation algorithms and an MDRO reporting form, helping ensure comparable data across facilities.

The framework also links HAI surveillance with infection prevention and control, antimicrobial resistance monitoring, outbreak response and Early Warning, Alert and Response Systems. It calls for phased implementation beginning with selected hospitals, regular training, audits and programme evaluation, with the SOP to be reviewed every five years or earlier if needed. A dedicated annex also requires surveillance to incorporate gender, equity, disability, confidentiality and human-rights considerations, while the document cautions that its case definitions should not automatically be applied to neonates without a separately adapted surveillance framework.