Abstract
An aim of the ECDC point prevalence survey (PPS) in European Union/European Economic Area acute care hospitals was to acquire standardised healthcare-associated infections (HAI) data. We analysed one of the most common HAIs in the ECDC PPS, healthcare-associated pneumonia (HAP). Standardised HAI case definitions were provided and countries were advised to recruit nationally representative subsets of hospitals. We calculated 95% confidence intervals (CIs) around prevalence estimates and adjusted for clustering at hospital level. Of 231,459 patients in the survey, 2,902 (1.3%; 95% CI: 1.2–1.3) fulfilled the case definition for a HAP. HAPs were most frequent in intensive care units (8.1%; 95% CI: 7.4–8.9) and among patients intubated on the day of the survey (15%; 95% CI: 14–17; n = 737 with HAP). The most frequently reported microorganism was Pseudomonas aeruginosa (17% of 1,403 isolates), followed by Staphylococcus aureus (12%) and Klebsiella spp. (12%). Antimicrobial resistance was common among isolated microorganisms. The most frequently prescribed antimicrobial group was penicillins, including combinations with beta-lactamase inhibitors. HAPs occur regularly among intubated and non-intubated patients, with marked differences between medical specialities. HAPs remain a priority for preventive interventions, including surveillance. Our data provide a reference for future prevalence of HAPs at various settings.
Highlights
Healthcare-associated pneumonia (HAP) causes a considerable burden of disease in the European Union/European Economic Area (EU/EEA) [1], which is at least partially preventable [2]
HAP was present in 2,902 patients resulting in a prevalence of 1.3% among hospitalised patients in acute care hospitals in Europe
The HAP prevalence varied between 0.6% in Latvia and 3.7% in Iceland (Pearson chisquared adjusted for clustering: p value < 0.0001 over all countries) (Figure)
Summary
Healthcare-associated pneumonia (HAP) causes a considerable burden of disease in the European Union/European Economic Area (EU/EEA) [1], which is at least partially preventable [2]. Surveillance of healthcare-associated infections (HAIs) can contribute to prevention by increasing awareness and by providing data for the prioritisation of interventions and for their subsequent evaluation [3]. Point prevalence surveys (PPSs) are a surveillance methodology well-suited to HAI surveillance. They are easier to conduct and much less costly than incidence surveillance of HAIs, even though they have drawbacks in terms of assessing causality and the overrepresentation of patients with long hospital stays [4]. Some PPSs did not specify the number of intubated patients, a group known to be at increased risk for HAP, while others reported cases of lower respiratory tract infections rather than pneumonia, limiting comparability across PPSs
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