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Nosocomial Infections (NIs) are considered to be serious public health problems around the world. The NI-related burden
is unknown because of lack of access to reliable data, lack of surveillance systems and the complexity of corresponding NI
outcomes. Health care systems use different approaches for monitoring NIs. Generally, surveillance methods are categorized under
the umbrellas of active, passive and sentinel surveillance methods. At present, hospitals implement passive surveillance approaches
because of feasibility and low cost. However, the quality of this methodology is in question; under reporting and lack of timeliness
are the main challenges. In contrast to the passive approach of NI surveillance systems, active ones do not face the challenge of realtime
detection of hospital-acquired infection and provide high quality data on the trends and burdens of NIs. This approach needs
extensive resources. Lessons learnt from the implementation of passive approaches to NI surveillance, especially in low and middle
income countries, have revealed the necessity of implementation of integrated sentinel surveillance methods using active approaches
at selected hospitals/health care facilities. Selecting representative hospitals can contribute to an appropriate understanding of NIrelated
burden.