Background and Objective: Healthcare-associated infections (HAIs) have a significant burden, particularly in long-term care facilities (LTCFs). Moreover, LTCFs were disproportionally affected by the COVID-19 pandemic. In preparation for the 2023 European Centre for Disease Prevention and Control (ECDC) “Point prevalence survey (PPS) of HAIs and antimicrobial use (AMU) in European long-term care facilities” (HALT), the Italian national coordinating team conducted a pilot PPS, with the Objective of establishing a regional surveillance network and assess the potential COVID-19 pandemic impact on HAIs. Methods: A PPS was conducted between May-June 2022. The protocol of this study is an updated version of the ECDC HALT-3. Seven Italian regions participated voluntarily enrolling a minimum of two LTCFs with at least 50 residents each, using convenience sampling. Data were collected in a single day in each LTCF, at the LTCF, ward, and resident levels. Resident data were collected for each resident with a HAI and/or AMU on the survey day. HAI and AMU prevalence were calculated as the mean number of residents with at least one HAI and/or AMU divided by the total number of eligible residents. Spearman’s correlational analysis was conducted between LTCF-level HAI and AMU prevalence. Results: 15 LTCFs with 1025 residents were included in the survey. HAI prevalence was 2.54% (95% CI 1.66%-3.69%) considering all HAIs and 1.56% (95% CI 0,89%-2.52%) not considering SARS-CoV-2 infections. The most frequent HAI was COVID-19 (30.3%). AMU prevalence was 3.02% (95% CI 0.21%-4,27%). The most prescribed agent was Ceftriaxone (48.4%). A positive correlation was found between LTCF-level HAI and AMU prevalence (Spearman’s ρ 0.395, p 0.0253). Conclusions: A national surveillance network was established. HAI prevalence was around one-third compared to 2017 Italian data, suggesting infection control activities could have improved following COVID-19 pandemic. Results will be useful to inform the 2023 ECDC HALT survey.