STUDY OF THE PREVALENCE OF HOSPITAL-ACQUIRED INFECTIONS IN THE TERTIARY HEALTH CARE INSTITUTION
Point prevalence study of healthcare-associated infections
Abstract
Healthcare-associated (HAIs) represent a major challenge to healthcare systems because they lead to increased morbidity, prolonged hospitalization with uncertain outcomes, and increased treatment costs.
The aim of the study: is to assess the situation regarding BI in a tertiary level health care institution.
Methods: HAI point prevalence study was conducted at the University Clinical Center Kragujevac (Serbia) during November 2022 within the national study. According to the method of the European Center for Disease Prevention and Control, trained teams collected data on patients who were admitted before 8 am in all departments of the hospital. Variables at the ward and patient level were analyzed.
Results: 567 patients were included in the study, and the prevalence of patients with at least one HAI was 8.3%, and the prevalence of HAI was 8.6%. The highest prevalence were in adult (34.6%) and pediatric/neonatology (21.2%) intensive care units. Pneumonia was the most frequently registered type of HAI (32.7%), followed by urinary tract infections (28.6%), while surgical site infections and blood infections were equally represented (16.3%). Among the 50 isolates, 24 (48.0%) were bacteria from the order Enterobacterales, followed by gram-negative non-fermenting bacilli with 24% (Acinetobacter spp. 14 and Pseudomonas aeruginosa 5 isolates), and 9 (18%) isolates belonged to Gram-positive cocci . The isolated pathogens showed a high degree of resistance to the tested antibiotics. Multivariate logistic regression identified the following independent risk factors for HAI: prolonged hospital stay, worse McCabe score, patient intubation and use of antimicrobial drugs.
Conclusion: The prevalence study enabled a quick overview of the basic epidemiological characteristics of HAI in our hospital and provided help in defining priorities for taking appropriate prevention measures.
References
2. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2011–2012. Stockholm: ECDC; 2013. Available at: http://www.ecdc.europa.eu/en/publications/Publications/healthcare-associated-infections-antimicrobial-use-PPS.pdf
3. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2016-2017. Stockholm: ECDC; 2023. Available at: https://www.ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-andantimicrobial-use-5
4. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; 2024. Available at: https://www.ecdc.europa.eu/en/publications-data/PPS-HAI-AMR-acute-care-europe-2022-2023
5. V Nacionalna studija prevalencije bolničkih infekcija i potrošnje antibiotika (2022). Ministarstvo zdravlja Republike Srbije, Beograd, 2024.
6. Metsini A, Vazquez M, Sommerstein R, et al. Point prevalence of healthcare-associated infections and antibiotic use in three large Swiss acute-care hospitals. Swiss Med Wkly 2018; 148: w14617.
7. Grae N, Singh A, Jowitt D, et al. Prevalence of healthcare-associated infections in public hospitals in New Zealand, 2021. J Hosp Infect 2023; 131:164-72.
8. Antonelli A, Ales ME, Chiecca G, eta al. Healthcare-associated infections and antimicrobial use in acute care hospitals: a point prevalence survey in Lombardy, Italy, in 2022. BMC Infect Dis 2024; 24(1):632.
9. Isigi SS, Parsa AD, Alasqah I, Mahmud I, Kabir R. Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review. JMIR Public Health Surveill 2023; 9:e43743.
10. Barbato D, Castellani F, Angelozzi A, et al. Prevalence survey of healthcare-associated infections in a large teaching hospital. Ann Ig 2019; 31(5): 423-35.
11. Point prevalence survey of health care- associated infections and antimicrobial use in European acute care hospitals. Protocol version 6.1, ECDC PPS 2022-2023 (dostupno:https://www.ecdc.europa.eu/sites/default/files/documents/antimicrobial-use-healthcare-associated-infections-point-prevalence-survey-version6-1.pdf).
12. European Committee on Antimicrobial Susceptibility Testing (EUCAST). New definitions of S, I and R from 2019.
13. Bolničke infekcije –definicije. Ministarstvo zdravlja i Institut za javno zdravlje Srbije, Beograd, 2022.
14. Vrijens F, Hulstaert F, Devriese S, van de Sande S. Hospital-acquired infections in Belgian acute-care hospitals: an estimation of their global impact on mortality, length of stay and healthcare costs. Epidemiol Infect 2012;140 (1):126-36.
15. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist 2018; 11:2321-33.
16. Semenova Y, Yessmagambetova A, Akhmetova Z, et al. Point-Prevalence Survey of Antimicrobial Use and Healthcare-Associated Infections in Four Acute Care Hospitals in Kazakhstan. Antibiotics 2024, 13, 981.
17. Nuvials X, Palomar M, Alvarez-Lerma F, et al. Health-care associated infections. Patient characteristics and influence on the clinical outcome of patients admitted to ICU. Envin-Helics registry data. Intensive Care Med Exp. 2015; 3(Suppl 1):A82.
18. Gorrie CL, Mirčeta M, Wick RR, et al. Genomic dissection of Klebsiella pneumoniae infections in hospital patients reveals insights into an opportunistic pathogen. Nat Commun. 2022; 13(1) :3017.
19. Palaiopanos K, Krystallaki D, Mellou K, et al. Healthcare-associated infections and antimicrobial use in acute care hospitals in Greece, 2022; results of the third point prevalence survey. Antimicrob Resist Infect Control 2024; 13(1):11.
20. Aghdassi SJS, Hansen S, Peña Diaz LA, et al. Healthcare-Associated Infections and the Use of Antibiotics in German Hospitals. Dtsch Arztebl Int 2024; 121 (9):277-83.
21. Vandael E, Latour K, Goossens H, et al. Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals: results of the Global-PPS and ECDC-PPS 2017. Antimicrob Resist Infect Control 2020;9(1):13.
22. Troillet N, Aghayev E, Eisenring MC, Widmer AF; Swissnoso. First Results of the Swiss National Surgical Site Infection Surveillance Program: Who Seeks Shall Find. Infect Control Hosp Epidemiol 2017; 38(6): 697–704.
23. Giamarellou H, Galani L, Karavasilis T, Ioannidis K, Karaiskos I. Antimicrobial Stewardship in the Hospital Setting: A Narrative Review. Antibiotics 2023, 12, 1557.
24. Abbas R, Chakkour M, Zein El Dine H, et al General Overview of Klebsiella pneumonia: Epidemiology and the Role of Siderophores in Its Pathogenicity. Biology (Basel). 2024; 13(2):78.
25. Loaiza WM, Ruiz AKR, Patiño CCO, Vivas MC. Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review. Acta Medica (Hradec Kralove) 2023; 66(1):1-10.
26. World health statistics. 2022: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.
27. Maki G, Zervos M. Health Care-Acquired Infections in Low- and Middle-Income Countries and the Role of Infection Prevention and Control. Infect Dis Clin N Am 2021; 35, 827–39.
28. Barbadoro P, Dolcini J, Fortunato C, et al. Point prevalence survey of antibiotic use and healthcare-associated infections in acute care hospitals: a comprehensive report from the Marche Region of Italy. J Hosp Infect 2023; 141: 80-87.
29. Zingg W, Metsini A, Balmelli C, et al. National point prevalence survey on healthcare-associated infections in acute care hospitals, Switzerland, 2017. Euro Surveill. 2019; 24 (32).
