Barbato D, Castellani F, Angelozzi A, Isonne C, Baccolini V, Migliara G, Marzuillo C, De Vito C, Villari P, Romano F, De Giusti M
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy - Hospital Hygiene Unit, Policlinico Umberto I Hospital, Rome, Italy.
Ann Ig. 2019 Sep-Oct;31(5):423-435. doi: 10.7416/ai.2019.2304.
Healthcare-associated infection (HAI) is the most frequent adverse event in healthcare settings. It is associated with increased mortality and antimicrobial resistance, leading to prolonged hospital stays and consistent financial loss for healthcare systems. The objective of this study was to estimate the burden of HAIs and antimicrobial use in the Teaching Hospital Policlinico Umberto I (THPUI) of Rome and to identify the most critical areas for intervention.
Data were collected according to the most recent ECDC point prevalence survey protocol in November 2018. Descriptive statistics for all variables were calculated. Univariate analysis was used to assess possible associations between variables and HAIs. Variables with a significance level of p<0.25 were included in a multiple logistic regression model.
A total of 799 patients were included in the analysis; of these, 13.3% presented with at least one HAI. Bloodstream infection was the most common, accounting for 30.9% of total infections. Overall, 125 microorganisms were isolated, with Enterobacteriaceae being the most frequent (32%). At the time of the survey, 49.1% patients were receiving antimicrobial therapy. The multivariate analysis showed a significant association between HAI and use of medical devices (OR=34.30; 95% CI:3.69-318.66), length of stay (OR=1.01; 95% CI:1.00-1.02) and exposure to prophylactic antimicrobial therapy (OR=0.23; 95% CI:0.11-0.47).
The ECDC methodology proved to be applicable to THPUI, where HAI prevalence was higher than the European standard (6.7%). This highlights the need to implement targeted measures to prevent and control HAIs, including continuous monitoring to evaluate the effectiveness of such interventions.
医疗保健相关感染（HAI）是医疗机构中最常见的不良事件。它与死亡率增加和抗菌药物耐药性相关，导致住院时间延长，并给医疗系统带来持续的经济损失。本研究的目的是估计罗马翁贝托一世教学医院（THPUI）中HAI和抗菌药物使用的负担，并确定最关键的干预领域。
根据2018年11月最新的欧洲疾病预防控制中心（ECDC）现患率调查方案收集数据。计算所有变量的描述性统计量。单因素分析用于评估变量与HAI之间的可能关联。显著性水平p<0.25的变量纳入多因素逻辑回归模型。
共有799例患者纳入分析；其中，13.3%的患者至少发生1次HAI。血流感染最为常见，占总感染的30.9%。总体而言，共分离出125种微生物，肠杆菌科最为常见（32%）。调查时，49.1%的患者正在接受抗菌治疗。多因素分析显示，HAI与医疗器械使用（OR=34.30；95%CI：3.69-318.66）、住院时间（OR=1.01；95%CI：1.00-1.02）和预防性抗菌治疗暴露（OR=0.23；95%CI：0.11-0.47）之间存在显著关联。
ECDC方法被证明适用于THPUI，该医院的HAI患病率高于欧洲标准（6.7%）。这凸显了实施针对性措施预防和控制HAI的必要性，包括持续监测以评估此类干预措施的有效性。
