Objective To investigate the healthcare-associated infection(HAI) status, common infection sites, and antimicrobial use in a county hospital in 2011-2015.Methods With combination of bedside survey and case history reviewing, HAI among all hospitalized patients at 0:00-24:00 on April 26, 2011, April 25, 2012, May 14, 2013, September 9, 2014, and August 12, 2015 were surveyed, survey data were analyzed by software SPSS17.0.Results A total of 5 165 patients participated in 5 surveys of HAI prevalence rate, 132 patients had 138 cases of HAI, prevalence rate and case prevalence rate were 2.56％ and 2.67％ respectively.Intensive care unit had the highest average HAI prevalence rate(22.58％).Lower respiratory tract was the main HAI site (58.70％), followed by urinary tract (12.32％), upper respiratory tract (10.14％), and skin soft tissue(5.07％).A total of 45 strains of pathogens were isolated, mainly gram-negative bacteria (n=30, 66.67％).The total usage rate of antimicrobial agents was 45.27％, in 5 prevalence surveys were 61.48％, 43.89％, 37.81％, 39.43％, and 44.79％ respectively.The main purpose of antimicrobial use was therapy (including therapy + prevention), accounting for 78.27％;monotherapy accounted for 81.27％.Conclusion Through prevalence rate survey for 5 consecutive years, HAI management departments can be more comprehensively understand HAI in key departments, key patients, key sites of HAI, and antimicrobial use in this hospital, and provide basis for the formulation and implementation of HAI prevention and control measures according to the actual situation of the hospital.