Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): an overview of the Italian situation

Furmenti, Maria Francesca; Rossello, P; Bianco, Serena; Olivero, E; Thomas, Robin; Emelurumonye, Ifeoma Nneka; Zotti, Carla Maria; Moro, Maria Luisa; Brusaferro, Silvio; Sticchi, C.; Chadenier, Giulia Marie; D’Errico, Marcello Mario; Ripabelli, Giancarlo; Prato, Rosa; Mura, I; Agodi, Antonella; Collini, Francesca; Torri, Emanuele; Novati, Roberto; Fedeli, Ugo

doi:10.1016/j.jhin.2019.02.007

Cited by 18 publications

(17 citation statements)

References 24 publications

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“…Point prevalence surveys from 23 European countries estimated HAI prevalence to be 6.5% in acute care hospitals and 3.9% in long-term care facilities [4]. This is consistent with recent trends observed in Italian healthcare settings, where the prevalence of HAI episodes was estimated to be between 6.5 and 7.1% in acute care [5,6] and between 3.4 and 3.9% in long-term care settings [6,7]. The levels of antimicrobial resistance were also high in both settings, most frequently affecting the bloodstream, lower respiratory tract, and surgical site [5,[8][9][10][11].…”

Section: Introductionsupporting

confidence: 76%

“…The prevalence of OIDRIs in the analysed database was lower than the European HAI prevalence, Italian HAI prevalence and Italian OIDRI prevalence, as described in recent surveys in acute care settings [4][5][6][7]. The decision to include only primary procedure and diagnosis codes may explain this underestimation, just as -in contrastthe inclusion of all episodes without checking for false positives such as multiple reports would probably result in an overestimation.…”

Section: Discussionmentioning

confidence: 80%

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Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study

Pirisi¹,

Pennestrì

Viganò

et al. 2020

BMC Infect Dis

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Background: Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study is to estimate 1) orthopaedic implantable device-related infection (OIDRI) prevalence in Italian hospitals and 2) the gap between the remuneration paid by the Italian healthcare system and the real costs sustained by Italian hospitals to treat these episodes. Methods: This is a cross-sectional study based on hospital discharge forms registered in 2012 and 2014. To address the first goal of this study, the national database was investigated to identify 1) surgical procedures associated with orthopaedic device implantation and 2) among them, which patient characteristics (age, sex), type of admission, and type of discharge were associated with a primary diagnosis of infection. To address the second goal, 1) each episode of infection was multiplied by the remuneration paid by the Italian healthcare system to the hospitals, based on the diagnosis-related group (DRG) system, and 2) the total days of hospitalization required to treat the same episodes were multiplied by the average daily cost of hospitalization, according to estimates from the Ministry of the Economy and Finance (MEF). Results: In 2014, 1.55% of the total hospitalizations for orthopaedic device implantation procedures were associated with a main diagnosis of infection, with a negligible increase of 0.04% compared with 2012. Hip and knee replacement revisions, male patients and patients older than 65 years were more exposed to infection. A total of 51.63% of patients were planned admissions to the hospital, 68.75% had an ordinary discharge to home, and 0.9% died. The remuneration paid by the healthcare system to the hospitals was € 37,519,084 in 2014, with 3 DRGs covering 70.6% of the total. The cost of the actual days of hospitalization to treat these episodes was 17.5 million more than the remuneration received. Conclusions: The OIDRI prevalence was lower than that described in recent surveys in acute care settings, although the numbers were likely underestimated. The cost of treatment varied significantly depending on the remuneration system adopted.

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Section: Introductionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 80%

Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study

Pirisi¹,

Pennestrì

Viganò

et al. 2020

BMC Infect Dis

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“…In M.F. Furmenti's et al [18] study, on a group of 957 reported HAI, the most commonly reported HAI were respiratory infections, especially those affecting the lower respiratory tract level (73.7%) and urinary tract infections 46.2%. Skin, gastrointestinal and eye/ear/mouth infections were of 15.7%, 7.7% and 5.2%.…”

Section: Discussionmentioning

confidence: 94%

Healthcare Associated Infections—A New Pathology in Medical Practice?

Voidăzan

Albu

Tóth³

et al. 2020

IJERPH

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Background: Hospital-acquired infections (HAI) contribute to the emotional stress and functional disorders of the patient and in some cases, can lead to a state of disability that reduces quality of life. Often, HAI are one of the factors that lead to death. The purpose of this study was to analyze the cases of HAI identified in public hospitals at the county level, through case report sheets, as they are reported according to the Romanian legislation. Methods: We performed a cross sectional study design based on the case law of the data reported to the Mures Public Health Directorate, by all the public hospitals belonging to this county. We tracked hospital-acquired infections reported for 2017-2018, respectively, a number of 1024 cases, which implies a prevalence rate of 0.44%, 1024/228,782 cases discharged from these hospitals during the studied period. Results: The most frequent HAIs were reported by the intensive care units (48.4%), the most common infections being the following: bronchopneumonia (25.3%), enterocolitis with Clostridioides difficile (23.3%), sepsis, surgical wound infections and urinary tract infections. At the basis of HAI were 22 pathogens, but the five most common germs were Clostridioides difficile, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Bronchopneumonia have been most frequently reported in intensive care units, the most common being identified the Acinetobacter baumannii agent. Sepsis and central catheter infections also appeared predominantly in intensive care units, more often with Klebsiella pneumoniae. The enterocolitis with Clostridioides difficile, were the apanage of the medical sections. Infections with Staphylococcus aureus have been identified predominantly in the surgical sections at the level of the surgical wounds. Urinary infections had a similar distribution in the intensive care units, the medical and surgical sections, with Klebsiella pneumoniae being the most commonly incriminated agent. Conclusions: We showed a clear correspondence between the medical units and the type of HAI: what recommends the rapid, vigilant and oriented application of the prevention and control strategies of the HAI. Author Contributions: Data curation, S.V., S.A. and I.M.; Funding acquisition, B.G. and A.R.; Investigation, S.V., Réka Toth and I.M.; Methodology, S.V. and S.A.; Resources, R.T., B.G., A.R. and I.M.; Supervision, S.V., S.A. and I.M.; Visualization, R.T. and B.G.; Writing-original draft, S.V. and A.R.; Writing-review and editing, S.A. and B.G. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Conflicts of Interest:The authors declare no conflict of interest.

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“…Studies conducted recently in the United Kingdom and the Netherland have indicated that the estimated prevalence of health care‐associated infections among hospital inpatients varies in the range of 4.3%–6.7% and that 2.6 million new cases of health care‐associated infection appear each year (Eikelenboom‐Boskamp et al, 2019; Wilson et al., 2019). In a study performed in long‐term care facilities in Italy, health care‐associated infection prevalence is reported to be 3.9% (Furmenti et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Examining the hand hygiene beliefs and practices of nursing students and the effectiveness of their handwashing behaviour

Ceylan

Güneş

Baran

et al. 2020

Journal of Clinical Nursing

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As members of the healthcare team, nursing students assume a large part of the treatment and care of patients during their clinical practice, and therefore, they play a vital role in preventing pathogenic contamination and the spread of contagious diseases (Labrague, McEnroe-Petitte, Van de Mortel, & Nasirudeen, 2018). For this reason, nursing students should be provided with the skills to adopt effective handwashing habits, which would be an important step in the direction

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Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): an overview of the Italian situation

Cited by 18 publications

References 24 publications

Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study

Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study

Healthcare Associated Infections—A New Pathology in Medical Practice?

Examining the hand hygiene beliefs and practices of nursing students and the effectiveness of their handwashing behaviour

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