scholarly journals Antimicrobial use in European acute care hospitals: results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017

2018 ◽  
Vol 23 (46) ◽  
Author(s):  
Diamantis Plachouras ◽  
Tommi Kärki ◽  
Sonja Hansen ◽  
Susan Hopkins ◽  
Outi Lyytikäinen ◽  
...  
Keyword(s):  
Acute Care ◽  
Antimicrobial Agents ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Surgical Prophylaxis ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Healthcare Associated

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials.

scholarly journals Antimicrobial use in acute care hospitals: national point prevalence survey on healthcare-associated infections and antimicrobial use, Switzerland, 2017

2019 ◽  
Vol 24 (33) ◽  
Author(s):  
Walter Zingg ◽  
Aliki Metsini ◽  
Céline Gardiol ◽  
Carlo Balmelli ◽  
Michael Behnke ◽  
...  
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Broad Spectrum Antibiotics ◽  
Healthcare Associated

Background A point prevalence survey (PPS) on healthcare-associated infections (HAI) and antimicrobial use was conducted in Swiss acute care hospitals in 2017. Aim Our objective was to assess antimicrobial use in Swiss acute care hospitals. Methods All patients hospitalised in any acute care hospital in Switzerland were eligible. We used the most recent version of the PPS protocol of the European Centre for Disease Prevention and Control. Results Data from 12,931 patients of 96 hospitals were collected. Of these, 4,265 (33%; 95% confidence interval (CI): 32.2–33.8) were on 5,354 antimicrobials for 4,487 indications. Most of the 2,808 therapeutic indications addressed 1,886 community-acquired infections (67.2%; 95% CI: 65.4–68.9). Of the 1,176 surgical prophylaxes, 350 (29.8%; 95% CI: 27.1–32.4) exceeded the duration of 1 day. Of the 1,090 antimicrobial regimens that were changed, 309 (28.3%; 95% CI: 25.7–31.0) were escalated and 337 (30.9%; 95% CI: 28.2–33.7) were de-escalated. Amoxicillin/clavulanic acid was the most frequent antimicrobial (18.8%; 95% CI: 17.7–19.8), prescribed mainly for therapeutic indications (76.0%; 95% CI: 73.3–78.7). A total of 1,931 (37.4%; 95% CI: 36.1–38.8) of the 5,158 antimicrobials for systemic use were broad-spectrum antibiotics, most frequently third- and fourth-generation cephalosporins (35.9%; 95% CI: 33.8–38.1). Conclusions Antimicrobial consumption was at European average, the use of broad-spectrum antibiotics in the lower third. Swiss acute care hospitals should invest in antimicrobial stewardship, particularly in reducing the use of broad-spectrum antibiotics.

scholarly journals A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: results from Serbian point prevalence survey, 2017

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Vesna Šuljagić ◽  
Milica Bajčetić ◽  
Vesna Mioljević ◽  
Gorana Dragovac ◽  
Biljana Mijović ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Surgical Patients ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Extrinsic Factors ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Healthcare Associated

Abstract Background As the only non-European Union (EU) country, Serbia participated in a second point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use (AMU) organized by the European Centre for Disease Prevention and Control (ECDC) in the EU countries. Here, we aimed to estimate the prevalence of HAI and AMU in patients who had recently undergone a surgery and to compare risk profile, HAI rates, and AMU among surgical patients and non-surgical patients. Methods A national PPS was performed in 65 Serbian acute-care hospitals, in November 2017. In this paper, the data of 61 hospitals for adult acute-care were analyzed. To ensure the comparability of study design we used the Serbian translation of ECDC case definitions and ECDC PPS protocol. The trained infection control staff, led by a hospital coordinator, reviewed medical records to identify HAI active at the time of the survey and AMU. Only inpatients admitted to the ward before 8 a.m. on the day if the survey were included. Results A total of 12,478 patients from 61 hospitals for adult acute-care were eligible for inclusion in this study. Significantly higher proportions of surgical patients were female, belonged to the 60-to-79 age group, and were less severely ill. Also, extrinsic factors (invasive devices, hospitalization at the ICU, and prior antibiotics therapy) were more frequent in surgical patients. Prevalence of HAIs was higher among surgical patients (261/3626; 7.2%) than among non-surgical patients (258/8852; 2.9%) (p < 0.0001). The highest prevalence of all HAIs was noted in patients who had kidney transplantation (4/11; 36.4%), while SSIs were the most prevalent among patients who had peripheral vascular bypass surgery (3/15; 20.0%). Non-surgical patients received treatment for community-acquired infections in significantly higher proportion (2664/8852; 64.3) (p < 0.001). Surgical prophylaxis for more than 1 day was applied in 71.4% of surgical patients. Conclusion We have provided an insight into the burden of HAIs and AMU among Serbia acute-care hospitals, and highlighted several priority areas and targets for quality improvement.

scholarly journals National point prevalence survey on healthcare-associated infections in acute care hospitals, Switzerland, 2017

2019 ◽  
Vol 24 (32) ◽  
Author(s):  
Walter Zingg ◽  
Aliki Metsini ◽  
Carlo Balmelli ◽  
Dionysios Neofytos ◽  
Michael Behnke ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Healthcare Associated Infections ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Point Prevalence Survey ◽  
Healthcare Associated

Background As a part of the national strategy on the prevention of healthcare-associated infections (HAI), a point prevalence survey (PPS) was conducted in acute care hospitals in Switzerland. Aim Our objective was to assess the burden of HAI in Swiss acute care hospitals. Methods All acute care hospitals were invited to participate in this cross-sectional survey during the second quarter of 2017. The protocol by the European Centre for Disease Prevention and Control was applied. Patients of all ages, hospitalised on the day of survey were included, except when admitted to outpatient clinics, emergency and psychiatry. Results Ninety-six acute care hospitals (79% of all hospitals ≥ 100 beds) provided data on 12,931 patients. Pooled and randomised HAI prevalences were 5.9% (95% confidence interval (CI): 5.5–6.3) and 5.4% (95% CI: 4.8–6.0), respectively. The HAI incidence was estimated at 4.5 (95% CI: 4.0–5.0). The most common type of HAI was surgical site infection (29.0%), followed by lower respiratory tract (18.2%), urinary tract (14.9%) and bloodstream (12.8%) infections. The highest prevalence was identified in intensive care (20.6%), in large hospitals > 650 beds (7.8%), among elderly patients (7.4%), male patients (7.2%) and patients with an ultimately (9.3%) or rapidly (10.6%) fatal McCabe score. Discussion This is the first national PPS of Switzerland allowing direct comparison with other European countries. The HAI prevalence was at European Union average (5.9% in 2016 and 2017), but higher than in some countries neighbouring Switzerland. Based on the limited information from previous surveys, HAI appear not to decrease.

scholarly journals Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012

2018 ◽  
Vol 23 (32) ◽  
Author(s):  
Jan Walter ◽  
Sebastian Haller ◽  
Chantal Quinten ◽  
Tommi Kärki ◽  
Benedikt Zacher ◽  
...  
Keyword(s):  
European Union ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
European Economic Area ◽  
Prevalence Survey ◽  
European Economic ◽  
Point Prevalence Survey ◽  
Economic Area ◽  
Healthcare Associated

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.

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