Regional point prevalence study of healthcare-associated infections and antimicrobial use in acute care hospitals in Liguria, Italy

Sticchi, Camilla; Alberti, Marisa; Artioli, Stefania; Assensi, M.; Baldelli, Ivana; Battistini, Angela; Boni, Sylvia De; Cassola, Giovanni; Castagnola, Elio; Cattaneo, Monica; Cenderello, Nadia; Cristina, Maria Luisa; Mite, Alex; Fabbri, Paola; Federa, F; Giacobbe, Daniele Roberto; Masa, Daniela La; Lorusso, C; Marioni, K; Masi, V M; Mentore, Bruno; Montoro, S; Orsi, Andrea; Raiteri, D; Riente, R; Samengo, I; Viscoli, Claudio; Carloni, R

doi:10.1016/j.jhin.2017.12.008

Cited by 31 publications

(29 citation statements)

References 14 publications

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“…Despite the intrinsic limitations of prevalence investigations [ 19 ], for the first time, an international protocol was used in Liguria region (Italy) for a regional survey [ 20 ], allowing us to compare our results with those of similar studies conducted at a national and European level. Moreover, point prevalence studies, when periodically repeated, yield a great deal of information on the size of the phenomenon, highlighting the potential effects of the adopted strategies.…”

Section: Study Limitationsmentioning

confidence: 99%

“…The aforementioned study allows [ 20 ], in theory, to compare the results of this paper with those of a similar environment from an epidemiological standpoint (at a national and European level). Unfortunately, the results are not directly comparable due to the different study protocol used in the 2007 survey; therefore, this most recent experience should be considered as a starting point and further assessments will be possible when future surveillance data are available, according to the Regional Prevention Plan 2014–2018, which requires to carry out a prevalence survey every year.…”

Section: Study Limitationsmentioning

confidence: 99%

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A Six-Year Point Prevalence Survey of Healthcare-Associated Infections in an Italian Teaching Acute Care Hospital

Gentili

Pumpo

Milìa

et al. 2020

IJERPH

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Healthcare-associated infections (HAI) represent one of the most common cause of infection and an important burden of disease. The aim of this study was to analyze the results of a six-year HAI point prevalence survey carried out yearly in a teaching acute care hospital from 2013 to 2018, following the European Center for Disease Prevention and Control (ECDC) guidelines. Surgical site infections, urinary tract infections, bloodstream infections, pneumonia, meningitis, and Clostridium difficile infections were considered as risk factors. A total of 328 patients with HAI were detected during the 6-year survey, with an average point prevalence of 5.24% (95% CI: 4.70%–5.83%). Respiratory tract infections were the most common, followed by surgical site infections, urinary tract infections, primary bloodstream infections, Clostridium difficile infections, and central nervous system infections. A regression model showed length of stay at the moment of HAI detection, urinary catheter, central venous catheter, and antibiotic therapy to be the most important predictors of HAI prevalence, yielding a significant adjusted coefficient of determination (adjusted R2) of 0.2780. This will provide future infection control programs with specific HAI to focus on in order to introduce a proper prophylaxis and to limit exposure whenever possible.

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Section: Study Limitationsmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

A Six-Year Point Prevalence Survey of Healthcare-Associated Infections in an Italian Teaching Acute Care Hospital

Gentili

Pumpo

Milìa

et al. 2020

IJERPH

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“…Based on only a few studies without defined information on sampling strategies, a bacterial or fungal co-infection rate of 8% in COVID-19 patients was estimated, but 72% of all these reported COVID-19 patients received (empiric broad-spectrum) antibiotic therapy [ 9 ]. Overuse of antimicrobials increases the risk for multi-resistant nosocomial secondary infections, which are associated with unfavourable clinical outcomes [ 17 ]. Therefore, practice of empirical antibiotic coverage in COVID-19 patients must be carefully evaluated.…”

Section: Introductionmentioning

confidence: 99%

Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship

Rothe

Feihl

Schneider

et al. 2020

Eur J Clin Microbiol Infect Dis

119

118

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The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded: The median age was 63.5 (range 17–99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1–13) days. Urinary antigen tests for Legionella pneumophila and Streptococcus peumoniae were negative in all cases. In critically ill patients admitted to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.

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“…Paediatric antimicrobial stewardship programmes may therefore play a critical role in reducing the emergence of bacterial resistance. However, previous studies of antibiotic use have often either not focused on children8–16 or have used cross-sectional designs,17 often in hospitals 18–21. A few studies have reported on trends in paediatric antibiotic use, in individual countries or regions or a small number of countries,22–25 using data on health insurance claims,22 pharmacy databases,23 community surveys24 and electronic health records 25…”

Section: Introductionmentioning

confidence: 99%

Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Jackson

Hsia

Bielicki³

et al. 2019

BMJ Glob Health

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IntroductionUnderstanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015.MethodsWe analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle-income and high-income countries (LMICs and HICs)). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid.ResultsAntibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs.ConclusionsAs measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing.

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Regional point prevalence study of healthcare-associated infections and antimicrobial use in acute care hospitals in Liguria, Italy

Cited by 31 publications

References 14 publications

A Six-Year Point Prevalence Survey of Healthcare-Associated Infections in an Italian Teaching Acute Care Hospital

A Six-Year Point Prevalence Survey of Healthcare-Associated Infections in an Italian Teaching Acute Care Hospital

Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship

Estimating global trends in total and childhood antibiotic consumption, 2011-2015

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