Point prevalence and risk factors for healthcare-associated infections in primary healthcare wards

Abstract

The aim of this study was to document the point prevalence of healthcare-associated infections (HAIs) in the public primary healthcare wards, which treat both acute and long-term care patients. We also assessed the risk factors for HAI and the consumption of alcoholic hand rubs and antibiotics. A cross-sectional study was performed in northern Finland in 2006 including all healthcare centers in the Oulu University Hospital district. There were 1,190 patients eligible for study in 44 public primary healthcare wards. The point prevalence of HAIs was 10.1%. The most common infections were urinary tract infections (30%), lower respiratory tract infections (27%), and skin and soft tissue infections (20%). The prevalence of HAIs did not depend on whether wards gave acute care, long-term care, or both acute and long-term care. In the multivariate analysis, the main risk factors for HAI were: more than three antibiotic prescriptions during the previous year, fully bedridden, renal disease, venous catheter, age over 80years, previous hospitalization during the past six months, and implanted foreign material. A prophylactic antibiotic was a protecting factor. Antimicrobial treatment was given for 18% of the study population and another 18% received prophylactic antimicrobials. HAIs are common in Finnish primary healthcare wards and there is a need to improve everyday practices in the wards in order to reduce the number of HAIs. It is also important to reduce the inappropriate use of antibiotics.