Abstract
The incidence of hospital-acquired infections differs with the country's economic development: in developed countries, the incidence rate ranges from 5 to 10%, while in developing countries it goes up to 25% or higher. The Fifth National Hospital-Acquired Infection Prevalence Study, conducted in 2022, was aimed at assessing the prevalence of HAI and the indicators of antibiotic use among hospitalized patients, especially during the COVID-19 pandemic. The objective of this paper was to assess the prevalence of hospital-acquired infections and the prevalence of patients with hospital-acquired infections, gain a comprehensive insight of the demographic characteristics of patients with and without hospital-acquired infections, as well as to determine the possible risk factors associated with the occurrence of hospital-acquired infections in Sremska Mitrovica General Hospital. Inclusion/exclusion criteria for patients and departments were in line with the methodology of the European Centre for Disease Prevention and Control (ECDC). The study included all patients admitted to the department prior to or at eight o'clock in the morning, who had not been discharged from the department at the time of the study. The statistical significance of the variables was estimated using ch2 and t-tests. Univariate logistic regression was performed. Group membership (patients with or without hospital-acquired infections) was considered a dependent variable, while all other variables were considered independent. All characteristics for which there was a statistically significant difference between the groups were entered into the multivariate logistic regression model. In the period from 16 November 2022 to 22 November 2022, the Fifth National Study of the Prevalence of Hospital-Acquired Infections and Use of Antibiotics was conducted in the Sremska Mitrovica General Hospital. Based on study inclusion/exclusion criteria for patients, at the time of the study, 240 patients who met the inclusion criteria had been hospitalized in different wards. The youngest hospitalized patient was <1 years old and the oldest was 86 years old (X=56.4; SD=23.2; MED=64.0). The longest hospitalization in the study was 77 days, and the shortest was shorter than one day, i.e., the patient had been admitted on the same day before eight o'clock in the morning (X=7.6; SD=11.2; MED=4.0). Univariate logistic regression found the following risk factors statistically significantly correlated with the onset of a hospital-acquired infection: hospitalization duration, placement of a central venous catheter, placement of a urinary catheter, intubation and use of antimicrobials. Multivariate logistic regression identified the following independent risk factors for hospital-acquired infection: prolonged hospital stay (aOR=0.18; 95%CI=0.06-0.54; p=0.003) and administration of antimicrobials (aOR=18.13; 95%CI=1.96-167.86; p=0.011). The Hosmer-Lemeshow goodness of fit test for this model of logistic regression was ꭕ2 = 0.700, p=0.983. Being that each hospital-acquired infection leads to prolonged hospitalization with all medical and economic consequences for the patient, staff and institution, continuous education of all staff, better implementation of existing procedures, together with formulation of strategies derived from future research, would contribute to reducing the burden of hospital-acquired infections on healthcare services with a positive impact on patient safety and well-being.
Published Version
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