scholarly journals Burden of Healthcare-Associated Infections in Sicily, Italy: Estimates from the Regional Point Prevalence Surveys 2016–2018

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1360
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Maria Clara La Rosa ◽  
Claudia La Mastra ◽  
Giuseppe Murolo ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Control Strategies ◽  
Point Prevalence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Uncertainty Interval ◽  
Life Years ◽  
Low Incidence ◽  
Healthcare Associated ◽  
And Control

An assessment of the burden of healthcare-associated infections (HAIs) in terms of disability-adjusted life years (DALYs) is useful for comparing and ranking HAIs and to support infection prevention and control strategies. We estimated the burden of healthcare-associated pneumoniae (HAP), bloodstream infection (HA BSI), urinary tract infection (HA UTI), and surgical site infection (SSI) in Sicily, Italy. We used data from 15,642 patients aged 45 years and above, identified during three repeated point prevalence surveys (PPSs) conducted from 2016 to 2018 according to the European Centre for Disease Prevention and Control protocol. The methodology of the Burden of Communicable Diseases in Europe project was employed. The selected HAIs accounted for 8424 DALYs (95% uncertainty interval (UI): 7394–9605) annually in Sicily, corresponding to 344 DALYs per 100,000 inhabitants aged 45 years and above (95% UI: 302–392). Notably, more than 60% of the burden was attributable to HAP, followed by HA BSI, SSI, and HA UTI. The latter had the lowest burden despite a relatively high incidence, whereas HA BSI generated a high burden even through a relatively low incidence. Differences between our estimates and those of European and Italian PPSs encourage the estimation of the burden of HAIs region by region.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

scholarly journals Burden of Healthcare-Associated Infections in Italy: Disability-Adjusted Life Years

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bordino ◽  
C Vicentini ◽  
A D'Ambrosio ◽  
F Quattrocolo ◽  
C M Zotti
Keyword(s):  
Prevention And Control ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Significant Burden ◽  
Tract Infections ◽  
Healthcare Associated ◽  
And Control

Abstract Background Healthcare-Associated Infections (HAIs) significantly increase adverse clinical outcomes and healthcare costs. In 2016 Italy participated in the second European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS) of HAIs and antimicrobial use in acute care hospitals. The aim of this study was to estimate the burden of the 5 most common HAIs in Italy, by evaluating incidence, attributable deaths, Years of Life Lost (YLL), Years Lived with Disability (YLD) and Disability-Adjusted Life-Years (DALYs). Methods National PPS data were used to establish sex- and age-specific incidence of Healthcare-associated Pneumonia (HAP), HA Urinary tract infections (HA UTI), HA Bloodstream Infections (HA BSI) excluding neonatal BSI, Surgical Site Infections (SSI), HA Clostridium Difficile infections (HA CDI). Patients' life expectancy was adjusted according to the severity of underlying conditions using the McCabe score. Following the methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project, an adapted version of the disease models of the BCoDE toolkit was used. Results An overall yearly incidence of 643434 new cases of HAI in Italy was estimated. The aggregate burden of the 5 HAIs was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL), corresponding to 702.53 DALYs per 100000 total population. HA BSI and HAP had the highest burden with respectively 253868.22? and 126038.26 DALYs. The population strata with the highest burden were the ones with McCabe Score 1 for every considered HAI. The age groups with the highest burden were 70-74 for male and 45-49 for female patients. In total, 56% of DALYs were attributable to men and 44% to women. Conclusions This nation-wide study found a significant burden of disease due to HAIs in Italy. Results of this study could be used to guide policy-makers in the implementation of measures aiming to reduce the impact of HAIs. Key messages This study estimated the burden of 5 HAIs in Italy was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL according to 2016 PPS data. Considering the significant burden of HAIs found in this study, infection prevention and control measures should be a Public Health priority in Italy.

scholarly journals Three-Year Trends of Healthcare-Associated Infections and Antibiotic Use in Acute Care Hospitals: Findings from 2016–2018 Point Prevalence Surveys in Sicily, Italy

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Maria Clara La Rosa ◽  
Claudia La Mastra ◽  
Giuseppe Murolo ◽  
...  
Keyword(s):  
Acute Care ◽  
Prevention And Control ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Significant Trend ◽  
Point Prevalence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

Repeated point prevalence surveys (PPSs) of healthcare-associated infections (HAIs) and antibiotic use are crucial to monitor trends over years at regional level, especially in countries with decentralized healthcare systems. Here, we reported the results of three PPSs conducted in Sicilian acute care hospitals (Italy) from 2016 to 2018, according to the European Centre for Disease Prevention and Control protocol. Overall, prevalence of patients with at least one HAI was 5.1% in 2016, 4.7% in 2017, and 5.1% in 2018, without a significant trend over years (p = 0.434). At the patient level, the most important factor associated with HAIs was antibiotic use, since patients receiving at least one antimicrobial were more likely to be infected than those who did not receive antimicrobials (OR = 18.87; 95%CI = 13.08–27.22). The analysis of the prevalence of antibiotic use indicated a significant trend across years of the PPSs: 50.5% of patients received at least one antimicrobial agent in 2016, 55.2% in 2017, and 53.7% in 2018 (p < 0.001). The most common indication for antimicrobial prescription was medical prophylaxis, while third-generation cephalosporins represented the most frequently used class of antimicrobial agents, followed by fluoroquinolones and combinations of penicillins. Our study confirms that HAIs still remain a major public health issue, which could be intensified by antibiotic abuse. This raises the need for infection prevention and control and antibiotic stewardship programs aimed to improve knowledge about appropriate antibiotic prescription and to reduce the use of broad-spectrum antimicrobials.

scholarly journals Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in India

BMJ ◽  
2017 ◽  
pp. j3768 ◽  
Author(s):  
Soumya Swaminathan ◽  
Jagdish Prasad ◽  
Akshay C Dhariwal ◽  
Randeep Guleria ◽  
Mahesh C Misra ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

scholarly journals A pre-pandemic COVID-19 assessment of the costs of prevention and control interventions for healthcare associated infections in medical and surgical units in Québec

2021 ◽  
Author(s):  
Eric Tchouaket ◽  
Stephanie Robins ◽  
Sandra Boivin ◽  
Drissa Sia ◽  
Kelley Kilpatrick ◽  
...  
Keyword(s):  
Best Practices ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Median Cost ◽  
Healthcare Associated ◽  
The Cost ◽  
And Control

Abstract Background Healthcare-associated infections (HCAIs) present a major public health problem that significantly affects patients, health care providers and the entire healthcare system. Infection prevention and control programs limit HCAIs and are an indispensable component of patient and healthcare worker safety. The clinical best practices (CBPs) of handwashing, screening, hygiene and sanitation of surfaces and equipment, and basic and additional precautions are keystones of infection prevention and control (IPC). Systematic reviews of IPC economic evaluations report the lack of rigorous empirical evidence demonstrating the cost-benefit of IPC program in general, and point to the lack of assessment of the value of investing in CBPs more specifically. Objective This study aims to assess overall costs associated with each of the four CBPs. Methods Across two Quebec hospitals, 48 healthcare workers were observed for two hours each shift, for two consecutive weeks. A modified time-driven activity-based costing framework method was used to capture all human resources (time) and materials required (e.g. masks, cloths, disinfectants) for each clinical best practice. Using a hospital perspective with a time horizon of one year, median costs per CBP per hour, as well as the cost per action, were calculated and reported in 2018 Canadian dollars. Sensitivity analyses were performed. Results A total of 1831 actions were recorded. The median cost of hand hygiene (N = 867) was 19.6 cents per action. For cleaning and disinfection of surfaces (N = 102), the cost was 21.4 cents per action, while cleaning of small equipment (N = 85) was 25.3 cents per action. Additional precautions median cost was $4.13 per action. The donning or removing or personal protective equipment (N = 720) cost was 75.9 cents per action. Finally, the total median costs for the five categories of clinical best practiced assessed were 27.2 cents per action. Conclusion The costs of clinical best practices were low, from 20 cents to $4.13 per action. This study provides evidence based arguments with which to support the allocation of resources to infection prevention and control practices that directly affect the safety of patients, healthcare workers and the public. Further research of costing clinical best care practices is warranted.

scholarly journals A pre-pandemic COVID-19 assessment of the costs of prevention and control interventions for healthcare associated infections in medical and surgical wards in Québec

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Eric Tchouaket Nguemeleu ◽  
Stephanie Robins ◽  
Sandra Boivin ◽  
Drissa Sia ◽  
Kelley Kilpatrick ◽  
...  
Keyword(s):  
Best Practices ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
The Cost ◽  
And Control

Abstract Background Healthcare-associated infections (HCAIs) present a major public health problem that significantly affects patients, health care providers and the entire healthcare system. Infection prevention and control programs limit HCAIs and are an indispensable component of patient and healthcare worker safety. The clinical best practices (CBPs) of handwashing, screening, hygiene and sanitation of surfaces and equipment, and basic and additional precautions (e.g., isolation, and donning and removing personal protective equipment) are keystones of infection prevention and control (IPC). There is a lack of rigorous IPC economic evaluations demonstrating the cost–benefit of IPC programs in general, and a lack of assessment of the value of investing in CBPs more specifically. Objective This study aims to assess overall costs associated with each of the four CBPs. Methods Across two Quebec hospitals, 48 healthcare workers were observed for two hours each shift, for two consecutive weeks. A modified time-driven activity-based costing framework method was used to capture all human resources (time) and materials (e.g. masks, cloths, disinfectants) required for each clinical best practice. Using a hospital perspective with a time horizon of one year, median costs per CBP per hour, as well as the cost per action, were calculated and reported in 2018 Canadian dollars ($). Sensitivity analyses were performed. Results A total of 1831 actions were recorded. The median cost of hand hygiene (N = 867) was 20 cents per action. For cleaning and disinfection of surfaces (N = 102), the cost was 21 cents per action, while cleaning of small equipment (N = 85) was 25 cents per action. Additional precautions median cost was $4.1 per action. The donning or removing or personal protective equipment (N = 720) cost was 76 cents per action. Finally, the total median costs for the five categories of clinical best practiced assessed were 27 cents per action. Conclusions The costs of clinical best practices were low, from 20 cents to $4.1 per action. This study provides evidence based arguments with which to support the allocation of resources to infection prevention and control practices that directly affect the safety of patients, healthcare workers and the public. Further research of costing clinical best care practices is warranted.

Healthcare governance and the modernisation of the NHS: infection prevention and control

2002 ◽  
Vol 3 (5) ◽  
pp. 16-25 ◽  
Author(s):  
R Pratt ◽  
S Morgan ◽  
J Hughes ◽  
A Mulhall ◽  
C Fry ◽  
...  
Keyword(s):  
Corporate Governance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Clinical Care ◽  
Clinical Governance ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

Q uality is central to the government's programme for modernising the NHS and clinical quality is at the heart of this agenda. The recent introduction of corporate governance with controls assurance and clinical governance in the NHS has established a framework for providing such excellence in clinical care. Governance applies to all healthcare activities and provides an ideal opportunity for infection prevention and control practitioners to improve the quality of their service and reduce the risk of patients acquiring preventable healthcare-associated infections (HAI). This paper will discuss the introduction of governance in the NHS, describe the key principles of clinical governance and relate these to infection prevention and control.

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