Multi-drug-resistant organisms are important issues in preventing healthcare-associated infections (HAIs); however, severe infection control in a hospital or healthcare facility cannot reduce HAIs. A surveillance system to detect multi-drug-resistant organisms is necessary in a prefecture or broader area including many healthcare facilities. The Ministry of Health, Labor and Welfare of Japan proposed to survey HAIs and multi-drug-resistant organisms in a region, and supported this surveillance by newly adding insurance points for regional infection control; however, definite actions were not presented and various trials have been attempted. In this symposium, several trials to survey multi-drug-resistant organisms in various regions were presented, and we searched for clues to prevent multi-drug-resistant organism infection.