INTRODUCTION:
Healthcare-associated infections (HAIs) represent a major public health issue, particularly in healthcare settings, and serve as an indicator of the quality and safety of care. The objectives of our study were to determine the prevalence of HAIs in a surgical university hospital in Tunisia and to identify its main associated factors.

METHODS:
We conducted a point prevalence survey of HAIs in June 2025, including all patients hospitalized at the Habib Bourguiba University Hospital in Sfax for more than 48 hours. HAIs were defined according to the Centers for Disease Control and Prevention (CDC) criteria.

RESULTS:
A total of 247 patients were included. The median age was 56 years (interquartile range (IQR)= [39-68.25] years), and the sex ratio was 1.71. Forty-seven patients had at least one HAI, representing a HAI prevalence of 19%. The median number of HAIs per patient was 2 (IQR = [1-3]). Urinary tract infections were the most identified site infections (34.7%, n = 25), followed by respiratory tract infections and surgical site infections (20.8%, n = 15) each. The most frequently isolated organisms were Klebsiella pneumoniae (18.2%, n=18) and Acinetobacter baumannii (16.2%, n=16). According to the antibiograms, 67.7% (n=23) of the isolates were multidrug-resistant. Multivariate analysis of factors associated with HAIs showed that hospitalization lasting 10 days or more (adjusted odds ratio (aOR)=15.04; p<0.001), transfer from another hospital or department (aOR=7.72; p=0.002), diabetes (aOR=7.3; p=0.002), and current urinary catheterization (aOR=4.47; p=0.025) were independently associated with the occurrence of HAIs.

CONCLUSIONS:
Our study revealed a higher prevalence of HAIs compared to previous national data. This underscores the importance of continuous prevention, surveillance, and control strategies of infections to enhance patient safety and improve the quality of care.