König Elisabeth, Meister Miriam, Pux Christian, Uhlmann Michael, Schippinger Walter, Friedl Herwig, Krause Robert, Zollner-Schwetz Ines
Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
Geriatric Health Centers of the City of Graz, 8020 Graz, Austria.
Antibiotics (Basel). 2025 Jun 3;14(6):573. doi: 10.3390/antibiotics14060573.
This study aimed to evaluate changes in the rate and spectrum of healthcare-associated infections (HCAIs) and to analyse the rate and spectrum of antimicrobial prescriptions in four long-term care facilities (LTCFs) in Graz, Austria, from 2018 to 2022 in a prospective cohort study. Nursing staff prospectively collected data on HCAIs and antimicrobial prescriptions once a week. Log-linear Poisson models for counts were applied mostly to evaluate the difference effects of the various calendar years compared to the reference year of 2018. A total of 1684 infections were recorded in 720 residents during the study period. The overall annual incidence rate of HCAIs varied over time with a significant increase to 2.86/1000 resident days in 2019 and to 4.09/1000 resident days in 2022, both compared to 2018, < 0.001. A large peak in respiratory tract infections (RTIs) occurred in winter 2021/2022 due to a large number of SARS-CoV-2 infections in all four LTCFs. Urinary tract infections (UTIs) were the most commonly recorded infections. Beta-lactams were the most frequently prescribed systemic anti-infectives. A statistically significant increase in the rate of beta-lactam prescriptions/1000 resident days occurred between 2018 and 2022 ( = 0.016), whereas a statistically significant decrease in quinolone prescriptions/1000 resident days occurred in the same time period ( < 0.001). The incidence rates of HCAIs varied over time with a significant increase during the COVID-19 pandemic in 2022 compared to 2018. Continued surveillance efforts are necessary to assess the effect of infection control efforts after the pandemic.
本研究旨在通过一项前瞻性队列研究，评估奥地利格拉茨市四家长期护理机构（LTCF）在2018年至2022年期间医疗保健相关感染（HCAI）的发生率和范围变化，并分析抗菌药物处方的发生率和范围。护理人员每周前瞻性收集一次有关HCAI和抗菌药物处方的数据。主要应用计数的对数线性泊松模型来评估与2018年参考年份相比，各历年的差异效应。在研究期间，共记录了720名居民的1684例感染。HCAI的总体年发病率随时间变化，与2018年相比，2019年显著增加至2.86/1000住院日，2022年增加至4.09/1000住院日，P<0.001。由于所有四家LTCF中大量的SARS-CoV-2感染，2021/2022年冬季呼吸道感染（RTI）出现了一个大高峰。尿路感染（UTI）是最常记录的感染类型。β-内酰胺类是最常用的全身性抗感染药物。2018年至2022年期间，每1000住院日β-内酰胺类处方率有统计学显著增加（P = 0.016），而同期喹诺酮类处方率每1000住院日有统计学显著下降（P<0.001）。与2018年相比，2022年COVID-19大流行期间HCAI的发病率随时间变化且显著增加。大流行后仍需持续监测以评估感染控制措施的效果。
