These technologies can be used to detect whether a patient is carrying a certain type of bacteria. Advanced screening technologies can provide sophisticated and rapid test findings before (e.g. during the pre-admission consultation) or on admission. This can help to reduce infection rates in patients during the medical intervention and facilitate the appropriate use of antibiotics while avoiding contaminating other patients and staff.

In high-income countries (HICs), 8 of 16 scenarios evaluating Point Of Care Testing (POCT) for respiratory tract infections were found to be cost-effective at the threshold of £33.80 per prescription avoided ⁶. More specifically, the use of C-reactive protein (CRP) point-of-care tests has been shown to significantly reduce antibiotic prescriptions for lower respiratory tract infections, without compromising either patients’ recovery or satisfaction with care ⁷.

Acute pharyngitis is a frequent cause of visits and antibiotic prescriptions in primary healthcare facilities ⁸. Although Streptococcus A is the cause of only 15% to 30% of cases, antibiotics are prescribed in 55% to 75% of cases ⁸. Rapid testing for Streptococcus A enables healthcare providers to accurately diagnose the cause of pharyngitis, thereby guiding the targeted use of antibiotics in any healthcare setting. According to a NICE Evidence Review, a significant reduction in initial antibiotic prescribing using Streptococcus A POCT has been found in 2 studies ⁹.

Influenza (commonly known as flu) is a highly contagious acute infection of the respiratory tract. Types A and B are the most common types of human influenza virus. They can circulate simultaneously, but usually one type is dominant during a seasonal epidemic. Although a flu infection is not normally severe, certain populations are at higher risk of developing complications. Rapid and accurate diagnosis means reducing the risk of transmission and outbreak, preventing inappropriate antibiotic use, and ensuring the early prescription of antiviral medication for high-risk patients.

Screening tests, such as chromogenic culture media, are ready-to-use tools for the selective isolation, enumeration, and identification of bacteria in 18-24 hours. They deliver more reliable differentiation of pathogens and multi-drug resistant organisms, faster and easier reading of results, and enhanced performance compared to traditional culture media.

A cost model found that targeted screening of at-risk patients at admission, combined with dedicated staff for identified carriers of Carbapenemase-producing Enterobacterales (CPE), was the most cost-effective intervention to control the spread of CPE ¹⁰. It justified €17,407 per avoided CPE case, with a reduction of 64% CPE acquisition.

Influenza-positive patients are 1.55 times more likely to be appropriately assigned to isolation facilities when tested with a rapid multiplex PCR test for respiratory viruses. This is an important tool for preventing nosocomial transmission, which can be costly for hospitals ¹¹.

Patients with positive viral detection by multiplex PCR have had fewer days of antibiotic therapy, fewer days of antivirals, and reduced length of stay ^{12 13.} This can translate to 31% lower median hospitalisation costs (€1,042 compared to €1,522), resulting in €22,834 in yearly savings, as well as reduced anxiety for the patient and their family.

These tests give reliable results in 30 minutes to 2 hours, making it a quick and easy way to control Carbapenemase producers while meeting diagnostic and screening challenges, improving patient management and controlling HAIs. The rapid detection time ensures that appropriate therapy and patient isolation measures are implemented.

Procalcitonin (PCT) helps differentiate bacterial from viral infections, and the early detection of an elevated PCT level in patients with suspected bacterial infections enables earlier antibiotic treatment. PCT also supports informed decisions on when to continue or discontinue antibiotics, thereby improving patient care and reducing antibiotic misuse, which helps control the emergence of antimicrobial resistance.

Rapid identification of the pathogen causing an infection is crucial for guiding diagnosis and antibiotic therapy. Innovative technologies, such as multiplex PCR systems, can identify a wide variety of bacterial, fungal, viral, and parasitic pathogens that cause respiratory, bloodstream, gastrointestinal, and meningitis infections, as well as antibiotic resistance genes, in just one hour. This enables the quick prescription of antibiotics and helps avoid misuse.

These procedures are essential for reducing the number of microbes in the area near the patient. It is also crucial to put in place personal protective barriers (e.g., gloves, gowns) to prevent healthcare workers from transferring bacteria to other patients.

Substantial reductions in catheter-related bloodstream infections can be achieved with the aid of advanced medical technologies, along with complementary improvements in practices. These include integrated safety catheter systems and closed IV access, alongside associated care and maintenance.

Catheter-related bloodstream infections (CRBSIs) incur an annual cost of €271 million to European healthcare systems. Substantial reductions in CRBSIs have been achieved with the aid of antiseptic-impregnated antimicrobial catheter dressings.

Evidence supports the case for adopting antimicrobial sutures as part of a comprehensive bundle of care to prevent surgical site infections in individuals who require wound closure following a surgical procedure. Cost modelling shows that antimicrobial sutures are cost-saving compared with standard absorbable sutures by an average of £13.62 per patient ¹⁷. These savings stem from a reduction in surgical site infections.

Hypothermia can occur as an adverse effect of surgical procedures and is a significant risk factor for developing Surgical Site Infections (SSIs), cardiac events, and the need for blood transfusions. The use of active patient warming techniques during the procedure is proven to significantly reduce the rate of these infections from developing. Furthermore, a medium cost saving of 16% per patient can be achieved, compared to the non-use of devices. Moreover, the social productivity cost is reduced by around 30% and the overall number of hospital days is reduced by between 15% and 26% ¹⁸.

The antiseptic contained in the drape is continuously released onto the skin during the procedure, preventing bacteria from contaminating the wound during the operation. These drapes prove to be cost-saving, as illustrated by the avoidance of 773 000 € for a series of 5100 consecutive cardiac surgery patients ¹⁹, due to the lower incidence of surgical site infections (SSIs) and consequently the avoidance of complication treatments.

Studies and cost models show that rapid diagnostics testing, associated with the prudent use of antibiotics, not only improves the quality of care but also generates cost savings of up to $27,537 per patient²⁰ – a win-win case for all stakeholders: patients, physicians, hospitals, healthcare systems, and society.

Studies and cost models have evaluated the budget impact of procalcitonin-guided antibiotic stewardship per patient, the reduction in the number of antibiotic resistance cases, and the cost per day of antibiotic consumption avoided. In a country like Belgium, this translates into savings of 1.98€ million, driven by a reduction of 666,868 antibiotic days ²¹.

Antibiotic therapy decisions can be assisted by innovative clinical decision support software. More timely and appropriate therapy can translate into substantial savings via the reduction of the cost of antibiotic therapy [-5 to -70%], the duration of length of stay [-1.6 to -17%], and personnel ^{22 33}, as well as better patient outcomes through reduced mortality.

Antibiotic susceptibility tests help identify which antibiotic(s) the bacterial infection will respond to and which ones it is resistant to. This, in turn, enables the physician to prescribe the appropriate medication to treat the patient and prevent misuse.

The use of special tubes can enable clinicians to manage subglottic secretion drainage (SSD), a technique that removes oral and/or gastric secretions containing bacterial pathogens, which may lead to serious complications, including Ventilator-Associated Pneumonia (VAP). Clinical investigations by Bouza et al. (2008) into the use of an edotracheal tube providing SSD found a 30% reduction in antibiotic use among the overall patient population, attributed to lower rates of VAP.

Surveillance systems play a key role in helping to conserve and steward the effectiveness of existing treatments, as well as supporting infection control practices by allowing clinicians to monitor infection scenarios and prescribe through the provision of bespoke triggers. By bringing together information from disparate sources, the system notifies practitioners of critical infection-related events, which aids clinicians in making targeted and timely interventions that prevent and control infections, and encourages the appropriate use of antibiotics to positively impact patient outcomes.

When it comes to combating infectious organisms, microbial identification (ID) and antibiotic susceptibility testing (AST) are crucial for providing accurate information for targeted clinical responses and improved patient care outcomes. Manual and automated tools, including mass spectrometry, are complementary and ensure fast and accurate results for prescribing the right antibiotic at the right concentration to the right patient. Software has been developed to help hospitals in reporting and surveillance of resistance.

ETESTs allow the detection and confirmation of resistant phenotypes for the most clinically relevant resistance mechanisms, including ESBLs (Extended-spectrum beta-lactamases), MBLs (Metallo-beta-lactamases) and AmpC beta-lactamases.

The more a hospital knows about the pathogens involved in an infection transmission or an outbreak, the better it can manage them. Services for Next Generation Sequencing-based genetic strain typing do exist that give extremely precise information about the disease agents suspected to be involved in infection transmission or HAI outbreaks. These powerful tools enable healthcare institutions and communities to make faster, better-targeted decisions, implement effective infection control measures, conduct more informed epidemiological investigations, reduce the incidence of future cases, and lower HAI-related healthcare management costs. Software tools are available for the surveillance of AMR at the hospital, regional, national and international levels.

Contaminated environmental surfaces are a significant source of pathogen transmission, including multi-resistant bacteria. These can cause severe infections, particularly in immunocompromised populations in hospitals.
Diagnostic tools can help to take control of the environment (including disinfection control).

Rapid surface testing technology enables the rapid and objective measurement of surface hygiene in under one minute. This technology helps measure, monitor and control hospital hygiene processes, enabling the delivery of continuous improvement in hygiene standards.

The World Health Organisation guidelines on the prevention of Surgical Site Infections (SSIs) suggest that the use of prophylactic Negative Pressure Wound Therapy (NPWT) may be used on high-risk patients for the purpose of preventing SSIs. Numerous studies in multiple surgical specialisations have been published, demonstrating the clinical and cost-effectiveness of NPWT for closed incision wounds following surgery. Cooper et al 2022) demonstrated a few surgical site complications (3.4% vs 13.3%; P=0.0013) and patients required fewer surgical (0.7% vs 4.8%; P=0.0666) and non-surgical (2.7% vs 12.9%; P=0.0017) interventions compared to those with standard of care. Respective total per-patient cost for the NPWT $1,047 compared to $2,036 for SOC in patients undergoing revision total knee arthroplasty. A further study by Svensson-Bjork et al. compared NPWT vs standard dressing after open inguinal vascular surgery and considered NPWT to be cost-effective over standard dressings due to the reduced SSI incidence (11.9% vs 30.8%; p=0.015) at no higher costs.

The appropriate use of antibiotics can be enabled at home through e-health, m-health, and other drug monitoring technologies. Misuse and non-adherence to antibiotic prescriptions are one of the key causes of the development of resistance.