A 2-year point-prevalence surveillance of healthcare-associated infections and antimicrobial use in Ferrara University Hospital, Italy

BMC Infectious Diseases - Tập 20 - Trang 1-8 - 2020
Paola Antonioli1, Niccolò Bolognesi2, Giorgia Valpiani3, Chiara Morotti3, Daniele Bernardini2, Francesca Bravi3, Eugenio Di Ruscio4, Armando Stefanati5, Giovanni Gabutti5
1Department of Hospital Hygiene & Healthcare-Associated Infection Risk Management, Hospital Health Medical Management, S. Anna University Hospital of Ferrara, Ferrara, Italy
2Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, Ferrara, Italy
3Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara, Ferrara, Italy
4Medical Director, S. Anna University Hospital of Ferrara, Ferrara, Italy
5Department of Medical Sciences, University of Ferrara, Ferrara, Italy

Tóm tắt

Healthcare-Associated Infections (HAIs) represent one of the leading issues to patient safety as well as a significant economic burden. Similarly, Antimicrobial Use (AMU) and Resistance (AMR) represent a growing threat to global public health and the sustainability of healthcare services. A Point Prevalence Survey (PPS) following the 2016 ECDC protocol for HAI prevalence and AMU was conducted at Ferrara University Hospital (FUH). Data were collected by a team of trained independent surveyors in 2016 and 2018. Risk factors independently associated with HAI were assessed by a multivariate logistic regression model. Of the 1102 patients surveyed, 115 (10.4%) had an active HAI and 487 (44.2%) were on at least 1 systemic antimicrobial agent. Factors independently associated with increased HAI risk were a “Rapidly Fatal” McCabe score (expected fatal outcome within 1 year), presence of medical devices (PVC, CVC, indwelling urinary catheter or mechanically assisted ventilation) and a length of hospital stay of at least 1 week. The most frequent types of HAI were pneumonia, bloodstream infections, and urinary tract infections. Antimicrobial resistance to third-generation cephalosporins was observed in about 60% of Enterobacteriaceae. The survey reports a high prevalence of HAI and AMU in FUH. Repeated PPSs are useful to control HAIs and AMU in large acute-care hospitals, highlighting the main problematic factors and allowing planning for improvement actions.

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