Surveillance of hospital-acquired infections and monitoring of empiric antibiotic therapy in an internal medicine department

Abstract

Introduction: Hospital-acquired infections (HAIs) are the most serious and frequent complication of healthcare systems. In 2019 the Marche Region has introduced a project to check HAIs and also the use of antibiotics in empirical therapy. The aim of this analysis was to conduct a periodic descriptive prevalence study according to the regional plan. Materials and Methods: In the quarter January-March 2020, the Internal Medicine Department of the Mazzoni Hospital of Ascoli Piceno has been considered, enrolling patients with HAIs to whom has been prescribed at least one antibiotic in empirical therapy. To assess the prevalence of multi-drug resistant organisms (MDRO), microbiological isolates were examined and laboratory response times were measured as a quality indicator. Besides, the incidence of HAIs from medical device, the clinical outcomes and the average length of stay have been analyzed. Results: The results show: high incidence of HAIs and high percentage of MDRO. The response time of the laboratory analysis is on average over 48-72 hours after sampling. The data show a widespread use of broad-spectrum antibiotics and low adherence to the new regional empiric therapy guidelines. Conclusions: The high incidence of HAIs implies the urgent need of an active surveillance of an Antimicrobial Stewardship team. This would represent a strategic solution to prevent and limit antimicrobial resistance and reduce morbidity, mortality and costs.