Abstract
A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8–2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.
Highlights
Healthcare-associated infections (HAIs) and antimicrobial resistance are well known major public health threats
Participating countries and hospitals In January 2010, European Centre for Disease Prevention and Control (ECDC) invited all national contact points for HAI surveillance and/or experts designated as national expert for the ECDC point prevalence survey (PPS) to participate in the pilot PPS study and enter at least one institution qualified as acute care hospital according to national definitions
The national contact points acted as national PPS coordinators and invited hospitals to participate on a voluntary basis
Summary
Healthcare-associated infections (HAIs) and antimicrobial resistance are well known major public health threats. The European Centre for Disease Prevention and Control (ECDC) proposed in 2008 that the total burden of HAIs should be measured regularly and in a standardised manner throughout the European Union (EU) [1]. The initial steps towards standardisation of surveillance of HAIs in Europe had been carried out on surgical site infections and infections in intensive care units by the ‘Hospitals in Europe Link for Infection Control through Surveillance (HELICS)’ project, from 2000 to 2003 [2,3,4,5,6]. Based on a review of 30 national or multicentre PPSs in 19 countries that had been carried out between 1996 and 2007 and included a total of 837,450 patients, ECDC estimated in 2008 the prevalence of HAIs in EU acute care hospitals to be on average of 7.1% [1]
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