Faculty of Medicine of Military Medical Academy, University of Defence, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Antimicrob Resist Infect Control. 2021 Mar 6;10(1):47. doi: 10.1186/s13756-021-00889-9.
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.
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.
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.
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.
作为唯一的非欧盟（EU）国家，塞尔维亚参与了由欧洲疾病预防控制中心（ECDC）在欧盟国家组织的第二次医疗保健相关感染（HAI）和抗菌药物使用（AMU）的点患病率调查。在这里，我们旨在估计最近接受手术的患者中 HAI 和 AMU 的患病率，并比较手术患者和非手术患者的风险状况、HAI 发生率和 AMU。
2017 年 11 月，在 65 家塞尔维亚急性护理医院进行了全国性的 PPS。在本文中，对 61 家成人急性护理医院的数据进行了分析。为了确保研究设计的可比性，我们使用了 ECDC 病例定义和 ECDC PPS 协议的塞尔维亚语翻译。受过培训的感染控制工作人员在医院协调员的带领下，查阅病历，以确定调查时发生的 HAI 和 AMU。只有在调查当天上午 8 点之前入住病房的住院患者才被纳入研究。
共有来自 61 家成人急性护理医院的 12478 名患者符合纳入本研究的条件。手术患者中女性、60-79 岁年龄组和病情较轻的比例明显较高。此外，手术患者中存在更多的外在因素（侵入性设备、入住 ICU 和之前使用抗生素治疗）。手术患者的 HAI 患病率（261/3626；7.2%）高于非手术患者（258/8852；2.9%）（p<0.0001）。所有 HAI 中，肾移植患者的患病率最高（4/11；36.4%），而外周血管旁路手术患者的 SSIs 患病率最高（3/15；20.0%）。非手术患者接受社区获得性感染治疗的比例明显更高（2664/8852；64.3%）（p<0.001）。71.4%的手术患者接受了超过 1 天的手术预防治疗。
我们深入了解了塞尔维亚急性护理医院的 HAI 和 AMU 负担，并强调了几个优先领域和质量改进的目标。
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