Hand hygiene (HH) is one of the most important infection prevention and control strategies at the hospital level. The aim of this study was to evaluate the potential COVID-19 pandemic impact on HH practices and rate of healthcare-associated infections. Data on alcohol-based handrub consumption (AHC) and antimicrobial resistance across 27 Italian hospitals over the period 2017–2021 were considered. Data on Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteria (CRE) were extracted from the antimicrobial resistance regional surveillance system. A significant increase was highlighted, with a peak in 2020 and a partial fall in 2021 for AHC (p < 0.001). The decrease in MRSA rates in 2021 compared to 2017–2019 was significant (p = 0.013). A significant Spearman’s correlation between AHC and CRE rates was found (Spearman’s ρ −0.646, p = 0.032). This study supports the importance of AHC monitoring and showed that improving AHC was an attainable goal in the COVID-19 era. However, other strategies are needed to maintain the high levels of AHC attained during the pandemic, in order to avoid a progressive drop that has already begun in 2021. Furthermore, our results support the inverse relationship between AHC and infection rates and antimicrobial-resistant bacteria.

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Background The pandemic may increase mental issues among children. This study aimed to explore parental perceptions on the pandemic impact on the health status of their children, with a focus on mental health. Methods An online nationwide cross-sectional study has been conducted amongst Italian parents (from April 2022-ongoing). The survey included: Strength and Difficulties Questionnaire (SDQ), Kessler-6 (K6) for parent's psychological distress, and pandemic-related items. The outcomes were: child's SDQ above the clinical cut-off and perceived child's worsening of sleep, appetite, physical and mental health during the pandemic. Multivariable regressions were run (p &lt; 0.05 as significant). Results Up to date, participants were 333 (88% female). Mean age was 40.7 years (SD = 6.7). Considering their children, 52.9% were female and mean age was 6.62 (SD = 4.3). A total of 12.6% of children passed the SDQ cut-off. Having parents who are healthcare workers (adjOR=4.1), having parents positive for K6 (adjOR=4.0) and having a poor economic situation (adjOR=3.9) were significantly associated with a higher probability of passing the cut-off. Considering the pandemic, 15.4% declared their child had worse sleep, 12.2% lower appetite, 6.6% more physical issues, and 22.9% more mental issues. Using electronic devices more than before the pandemic was significantly associated with worsening of sleep (adjOR=2.9) and appetite (adjOR=6.9). Having parents who are healthcare workers was significantly associated with worsening of sleep (adjOR=2.3) and mental health (adjOR=2.4). Having parents positive for K6 was significantly associated with worsening of mental health (adjOR=5.3). Conclusions This study suggested a perceived substantial worsening of children's health, especially considering mental health. Exploring how parents recognize their children's health and how the COVID-19 has changed daily habits should be considered as a public health priority in Europe. Key messages