1887
Surveillance Open Access
Like 1

Abstract

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4–7.8%) patients in ACH and 3.9% (95% cCI: 2.4–6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022–117,484) in ACH and 129,940 (95% cCI: 79,570–197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6–15.6 million), including 4.5 million (95% cCI: 2.6–7.6 million) in ACH and 4.4 million (95% cCI: 2.0–8.0 million) in LTCF; 3.8 million (95% cCI: 3.1–4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2018.23.46.1800516
2018-11-15
2018-12-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.46.1800516
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/23/46/eurosurv-23-46-6.html?itemId=/content/10.2807/1560-7917.ES.2018.23.46.1800516&mimeType=html&fmt=ahah

References

  1. Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank HP, Ducomble T, et al. Burden of six healthcare-associated infections on European population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study. PLoS Med. 2016;13(10):e1002150.  https://doi.org/10.1371/journal.pmed.1002150  PMID: 27755545 
  2. Cassini A, Colzani E, Pini A, Mangen MJ, Plass D, McDonald SA, et al. Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013. Euro Surveill. 2018;23(16):17-00454.  https://doi.org/10.2807/1560-7917.ES.2018.23.16.17-00454  PMID: 29692315 
  3. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2011-2012. Stockholm: ECDC; 2013. Available from: http://www.ecdc.europa.eu/en/publications/Publications/healthcare-associated-infections-antimicrobial-use-PPS.pdf
  4. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. May–September 2010. Stockholm: ECDC; 2014. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/healthcare-associated-infections-antimicrobial-consumption-point-prevalence-survey-long-term-care-facilities-2010.pdf
  5. Suetens C. Healthcare-associated infections in European long-term care facilities: how big is the challenge? Euro Surveill. 2012;17(35):20259. PMID: 22958606 
  6. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. April–May 2013. Stockholm: ECDC; 2014. Available from: http://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/healthcare-associated-infections-point-prevalence-survey-long-term-care-facilities-2013.pdf
  7. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Protocol version 5.3. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/PPS-HAI-antimicrobial-use-EU-acute-care-hospitals-V5-3.pdf
  8. European Centre for Disease Prevention and Control (ECDC). Protocol for point prevalence surveys of healthcare-associated infections and antimicrobial use in European long-term care facilities. Version 2.1. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/HALT-3-LTCF-PPS-Protocol-v2.1.pdf
  9. Eurostat database. Health care facilities. Hospital beds by type of care. [Accessed: 12 October 2018]. Available from: https://ec.europa.eu/eurostat/web/products-datasets/-/hlth_rs_bds
  10. Eurostat database. Health care activities. Hospital discharges and length of stay for inpatient and curative care. [Accessed 12 October 2018]. Available from: https://ec.europa.eu/eurostat/web/products-datasets/-/hlth_co_dischls
  11. Eurostat database. Health care facilities. Long-term care beds in nursing and residential care facilities by NUTS 2 regions. [Accessed 17 Jul 2018]. Available from: https://ec.europa.eu/eurostat/web/products-datasets/-/hlth_rs_bdsns
  12. European Centre for Disease Prevention and Control (ECDC). Surveillance of antimicrobial resistance in Europe 2016. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2017. Available from https://ecdc.europa.eu/sites/portal/files/documents/AMR-surveillance-Europe-2016.pdf
  13. European Centre for Disease Prevention and Control (ECDC). Data from the ECDC Surveillance Atlas - Antimicrobial resistance. Stockholm: ECDC. [Accessed: 24 August 2018]. Available from https://ecdc.europa.eu/en/antimicrobial-resistance/surveillance-and-disease-data/data-ecdc
  14. Rhame FS, Sudderth WD. Incidence and prevalence as used in the analysis of the occurrence of nosocomial infections. Am J Epidemiol. 1981;113(1):1-11.  https://doi.org/10.1093/oxfordjournals.aje.a113058  PMID: 7457475 
  15. Jankowski HK, Wellner JA. Estimation of a discrete monotone distribution. Electron J Stat. 2009;3(0):1567-605.  https://doi.org/10.1214/09-EJS526  PMID: 20419057 
  16. European Centre for Disease Prevention and Control (ECDC). Protocol for validation of point prevalence surveys of healthcare-associated infections and antimicrobial use in European long-term care facilities. 2016-2017 version 1.1. Stockholm: ECDC; 2016. Available from https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/HALT-3-Validation-Protocol-v1.1.pdf
  17. Gastmeier P, Bräuer H, Sohr D, Geffers C, Forster DH, Daschner F, et al. Converting incidence and prevalence data of nosocomial infections: results from eight hospitals. Infect Control Hosp Epidemiol. 2001;22(1):31-4.  https://doi.org/10.1086/501821  PMID: 11198019 
  18. Meijs AP, Ferreira JA, DE Greeff SC, Vos MC, Koek MB. Incidence of surgical site infections cannot be derived reliably from point prevalence survey data in Dutch hospitals. Epidemiol Infect. 2017;145(5):970-80.  https://doi.org/10.1017/S0950268816003162  PMID: 28065193 
  19. Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2018. Published ahead of print.
  20. Council of the European Union. Council Recommendation of 9 June 2009 on patient safety, including the prevention and control of healthcare associated infections. Official Journal of the European Union. 2009. C 151/1. Available from: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2009:151:0001:0006:EN:PDF
  21. Zingg W, Holmes A, Dettenkofer M, Goetting T, Secci F, Clack L, et al. systematic review and evidence-based guidance on organization of hospital infection control programmes (SIGHT) study group. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis. 2015;15(2):212-24.  https://doi.org/10.1016/S1473-3099(14)70854-0  PMID: 25467650 
  22. World Health Organization (WHO). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. Geneva: WHO; 2016. Available from: http://www.who.int/gpsc/ipc-components-guidelines/en/
  23. World Health Organization (WHO). Global guidelines for the prevention of surgical site infection. Geneva: WHO; 2016. Available from: http://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf;jsessionid=D9392589CE8819145EC804EA139481F3?sequence=1.
  24. Tschudin-Sutter S, Kuijper EJ, Durovic A, Vehreschild MJGT, Barbut F, Eckert C, et al. Committee. Guidance document for prevention of Clostridium difficile infection in acute healthcare settings. Clin Microbiol Infect. 2018;24(10):1051-4.  https://doi.org/10.1016/j.cmi.2018.02.020  PMID: 29505879 
  25. European Centre for Disease Prevention and Control (ECDC). Systematic review and evidence-based guidance on perioperative antibiotic prophylaxis. Stockholm: ECDC; 2013. Available from: https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Perioperative%20antibiotic%20prophylaxis%20-%20June%202013.pdf
/content/10.2807/1560-7917.ES.2018.23.46.1800516
Loading

Data & Media loading...

Supplementary data

Comment has been disabled for this content
Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error