Objective To understand the healthcare-associated infection (HAI) and device-associated infection in the intensive care units (ICU), and provide scientific basis for HAI management. Methods HAI monitoring data of patients in ICU in a tertiary first-class hospital from January 2019 to December 2021 were collected and conducted statistical analysis. Results A total of 2 302 patients were monitored, and 120 patients (138 cases) had HAI.Incidence and cases incidence of HAI were 5.21% and 5.99% respectively.There were no statistically significant differences in incidence of HAI and case incidence of HAI in 2019-2021(all P>0.05).The main HAI site was lower respiratory tract (n=96 cases, 69.57%), followed by the urinary tract (n=28 cases, 20.29%) and bloodstream (n=6 cases, 4.35%).A total of 125 strains of pathogens were isolated, with Gram-negative bacteria being the main strain, accounting for 74.40%.The incidence of central catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) were 0.34‰, 1.47‰, and 8.65‰, respectively.Over the past three years, the incidence of device-associated infection decreased and VAP decreased significantly (both P < 0.05).Among healthcare-associated non-device-associated infection, the proportion of pulmonary infection increased from 23.53% to 46.00%, with a statistically significant difference (P < 0.05). Conclusion Three consecutive years of targeted monitoring showed that the incidence of catheter-associated infection decreased, but the incidence of non-device-associated infection increased.HAI management should strength the monitoring of the implementation of HAI prevention and control measures for non-mechanically ventilated patients, so as to reduce the overall incidence of HAI in ICU.