Trends, risk factors and outcomes of healthcare-associated infections within the Italian network SPIN-UTI

Agodi, Antonella; Auxilia, F.; Barchitta, Martina; Brusaferro, Silvio; D'Alessandro, D; Grillo, Orazio Claudio; Montagna, Maria Teresa; Pasquarella, Cesira; Righi, Elena; Tardivo, Stefano; Torregrossa, V.; Mura, I

doi:10.1016/j.jhin.2013.02.012

Cited by 38 publications

(27 citation statements)

References 15 publications

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“…12 ). Numerous multi-centre studies confirm the consistency of these results with the outcomes presented in this study [11][12][13][14] . However, a detailed data review indicates differences in the HAI epidemiology between Polish ICUs and the HAI-Net data, which may be related to the organization of work and the system of HAI surveillance.…”

Section: Discussionsupporting

confidence: 88%

Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance

Wałaszek

Różańska

Bulanda

et al. 2018

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Despite the lack of widely implemented active targeted surveillance programmes and top-down incentives, it is possible to carry out effective surveillance of HAIs in ICUs in Poland. The results of this study are comparable with the ECDC data, but the results are alarmingly high in two fields: epidemiology of PN and BSIs and very high antibiotic resistance in Gram-negative rods, which indicate the need for intense control in this area and for further studies to clarify the source of the observed discrepancy.

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Section: Discussionsupporting

confidence: 88%

Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance

Wałaszek

Różańska

Bulanda

et al. 2018

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Moreover, benchmarking of HAIs surveillance protocols in NICUs is available on a national scale for NHSN [4][5][6], NEO-KISS [10,11], the Vermont Oxford Network [7,8], the neonIN network [12], and the Canadian Neonatal network [9]. A national framework for the surveillance of HAIs in Italy-SPIN-UTI project is active in Italy since 2008, which involves adult Intensive care units (ICUs) with none of NICUs [13,14]. Although no surveillance network for HAIs in NICUs is present in Italy, few studies reported the prevalence [15], incidence of HAIs [16][17][18][19][20] and epidemics of specific nosocomial pathogens [20][21][22][23][24] in selected Italian NICUs.…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Trends, risk factors and outcomes of healthcare-associated infections in a neonatal intensive care unit in Italy during 2013–2017

et al. 2020

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Background: Healthcare-associated infections (HAIs) occur frequently in intensive care units (NICUs). The aim of this study was to analyze the results of surveillance of HAIs in a III level NICU in Naples, Italy during 2013-2017 and to compare with those obtained during 2006-2010. Methods:The surveillance included 1265 neonates of all birth weight (BW) classes with > 2 days NICU stay. Infections were defined using standard Centers for Disease Control and Prevention definitions adapted to neonatal pathology.Results: A total of 125 HAIs were registered during 2013-2017 with a frequency of 9.9% and an incidence density of 3.2 per 1000 patient days. HAIs occurred in all BW classes with a decreasing trend from the lowest to the highest BW classes (p = < 0.001). Central line-associated blood stream infection (CLABSI) was the most frequent infection (69.6%), followed by ventilator associated pneumonia (VAP) (20%), urinary tract infection (UTI) (8.8%) and necrotizing enterocolitis (NEC) (1.6%). Also, CLABSI and VAP incidence density decreased from lower to highest BW classes showing a significant trend (p = 0.007). Most frequent pathogens responsible for CLABSI were: Coagulase-negative staphylococci (CONS) (25.3%), Candida parapsilosis (21.8%), Pseudomonas aeruginosa (5.7), Escherichia coli and Klebsiella pneumoniae (6.8%). No microbiological diagnosis was achieved for 20.7% of CLABSI. Pseudomonas aeruginosa (28%), Stenotrophomonas maltophilia (20%), and CONS (20%) were the most frequent pathogens responsible for VAP. CLABSI incidence density showed no differences between 2006 and 2010 and 2013-2017, while VAP incidence density for the 751-100 g BW class was higher during 2006-2010 than during 2013-2017 (p = 0.006). A higher incidence of the CLABSI caused by Gram positive bacteria (p = 0.002) or by undetermined etiology (p = 0.01) was observed during 2013-2017 than during 2006-2010, while a significant lower incidence of VAP caused by Gram-negative bacteria was found during

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“…In Europe, the most recent report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) describes a general increase of AMR in the Gram-negative pathogens including Klebsiella pneumoniae and A. baumanni [ 1 ]. In Italy, the results of the Italian Nosocomial Infections Surveillance in Intensive Care Units (SPIN-UTI) network revealed that K. pneumoniae and A. baumanni are among the most commonly isolated microorganisms in intensive care unit (ICU)-acquired infections [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic trends of Klebsiella pneumoniae and Acinetobacter baumannii resistance indicators in an intensive care unit of Southern Italy, 2008–2013

Agodi

Barchitta

Quattrocchi

et al. 2015

Antimicrob Resist Infect Control

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BackgroundThe overuse of antimicrobials is one of the main factors responsible for the development and spread of antimicrobial resistance, together with other causes, such as intra- and inter-hospital spread of resistant microorganisms and infection control policies and practices. The objective of the present study is to report the trends of Klebsiella pneumoniae and Acinetobacter baumannii antimicrobial resistance indicators in an Italian intensive care unit (ICU) during a six-year period, from 2008 to 2013.MethodsSusceptibility data and annual antibiotic consumptions in the ICU were retrospectively obtained from the clinical laboratory and the pharmacy. Trends over time of resistance rates (RRs) and of incidence densities of resistant isolates were determined by linear regression.ResultsIsolation density of A. baumannii increased significantly from 2008 (20.4 per 1,000 patient-days) to 2013 (58.1 per 1,000 patient-days) and of K. pneumoniae from 2010 (22.3 per 1,000 patient-days) to 2013 (55.9 per 1,000 patient-days). RRs of third-generation cephalosporins (3GCs)-resistant K. pneumoniae (from 2010: 41.9 %, to 2012: 87.0 %), of carbapenem-resistant K. pneumoniae (from 2008: 0 %, to 2013: 59.2 %), and of carbapenem-resistant A. baumannii (from 2008: 87.5 %, to 2013: 96.6 %) showed significant increasing trends. Carbapenems was the main antibiotic class consumed (24.9 % of the total antimicrobial usage density), followed by 3GCs (21.0 %), fluoroquinolones (20.6 %), aminoglycosides (17.3 %), penicillins (15.1 %) and glycopeptides (1.1 %). Carbapenems consumption decreased from 2008 to 2012 and then increased in 2013. Glycopeptides consumption decreased from 2008 to 2011 and then increased in 2013. Aminoglycosides consumption decreased from 2008 to 2010 and increased from 2012 to 2013. Finally, 3GC, penicillins and fluoroquinolones consumptions decreased from 2012 to 2013.ConclusionsRRs of carbapenem-resistant A. baumannii and of carbapenem- and 3GC-resistant K. pneumoniae were higher than those for Europe. Our findings highlight the necessity to implement an integrated system for monitoring not only consumption of antibiotics and resistance profiles but also the clonality of alert microorganisms in the ICU for effective infection control.

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Trends, risk factors and outcomes of healthcare-associated infections within the Italian network SPIN-UTI

Cited by 38 publications

References 15 publications

Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance

Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance

Trends, risk factors and outcomes of healthcare-associated infections in a neonatal intensive care unit in Italy during 2013–2017

Antibiotic trends of Klebsiella pneumoniae and Acinetobacter baumannii resistance indicators in an intensive care unit of Southern Italy, 2008–2013

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