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Abstract

Background

As a part of the national strategy on the prevention of healthcare-associated infections (HAI), a point prevalence survey (PPS) was conducted in acute care hospitals in Switzerland.

Aim

Our objective was to assess the burden of HAI in Swiss acute care hospitals.

Methods

All acute care hospitals were invited to participate in this cross-sectional survey during the second quarter of 2017. The protocol by the European Centre for Disease Prevention and Control was applied. Patients of all ages, hospitalised on the day of survey were included, except when admitted to outpatient clinics, emergency and psychiatry.

Results

Ninety-six acute care hospitals (79% of all hospitals ≥ 100 beds) provided data on 12,931 patients. Pooled and randomised HAI prevalences were 5.9% (95% confidence interval (CI): 5.5–6.3) and 5.4% (95% CI: 4.8–6.0), respectively. The HAI incidence was estimated at 4.5 (95% CI: 4.0–5.0). The most common type of HAI was surgical site infection (29.0%), followed by lower respiratory tract (18.2%), urinary tract (14.9%) and bloodstream (12.8%) infections. The highest prevalence was identified in intensive care (20.6%), in large hospitals > 650 beds (7.8%), among elderly patients (7.4%), male patients (7.2%) and patients with an ultimately (9.3%) or rapidly (10.6%) fatal McCabe score.

Discussion

This is the first national PPS of Switzerland allowing direct comparison with other European countries. The HAI prevalence was at European Union average (5.9% in 2016 and 2017), but higher than in some countries neighbouring Switzerland. Based on the limited information from previous surveys, HAI appear not to decrease.

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/content/10.2807/1560-7917.ES.2019.24.32.1800603
2019-08-08
2024-10-13
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.32.1800603
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References

  1. Ista E, van der Hoven B, Kornelisse RF, van der Starre C, Vos MC, Boersma E, et al. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(6):724-34.  https://doi.org/10.1016/S1473-3099(15)00409-0  PMID: 26907734 
  2. Pileggi C, Mascaro V, Bianco A, Nobile CGA, Pavia M. Ventilator bundle and its effects on mortality among ICU patients: a meta-analysis. Crit Care Med. 2018;46(7):1167-74.  https://doi.org/10.1097/CCM.0000000000003136  PMID: 29629985 
  3. 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 
  4. 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 
  5. Staszewicz W, Eisenring MC, Bettschart V, Harbarth S, Troillet N. Thirteen years of surgical site infection surveillance in Swiss hospitals. J Hosp Infect. 2014;88(1):40-7.  https://doi.org/10.1016/j.jhin.2014.06.003  PMID: 25063012 
  6. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, de Jonge S, de Vries F, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016;16(12):e288-303.  https://doi.org/10.1016/S1473-3099(16)30402-9  PMID: 27816414 
  7. Zingg W, Cartier V, Inan C, Touveneau S, Theriault M, Gayet-Ageron A, et al. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. PLoS One. 2014;9(4):e93898.  https://doi.org/10.1371/journal.pone.0093898  PMID: 24714418 
  8. Zingg W, Huttner BD, Sax H, Pittet D. Assessing the burden of healthcare-associated infections through prevalence studies: what is the best method? Infect Control Hosp Epidemiol. 2014;35(6):674-84.  https://doi.org/10.1086/676424  PMID: 24799644 
  9. Zingg W, Hopkins S, Gayet-Ageron A, Holmes A, Sharland M, Suetens C, et al. Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. Lancet Infect Dis. 2017;17(4):381-9.  https://doi.org/10.1016/S1473-3099(16)30517-5  PMID: 28089444 
  10. Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VP, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol. 1985;121(2):182-205.  https://doi.org/10.1093/oxfordjournals.aje.a113990  PMID: 4014115 
  11. Wolkewitz M, Mandel M, Palomar-Martinez M, Alvarez-Lerma F, Olaechea-Astigarraga P, Schumacher M. Methodological challenges in using point-prevalence versus cohort data in risk factor analyses of nosocomial infections. Ann Epidemiol. 2018;28(7):475-480.e1.  https://doi.org/10.1016/j.annepidem.2018.03.017  PMID: 29661679 
  12. 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: https://ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-0
  13. 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/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-3
  14. Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro ML, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018;23(46):1800516.  https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516  PMID: 30458912 
  15. Sax H, Ruef C, Pittet D. Results of the Swiss prevalence study on nosocomial infections 2003 (snip03). [Resultate der Schweizerischen Prävalenzstudie nosokomialer Infektionen 2003 (snip03)]. Swissnoso Bull.2004;11:1-8. German.
  16. Sax H, Pittet D. Results of the Swiss prevalence study on nosocomial infections 2004 (snip04). [Resultate der Schweizerischen Präalenzstudie der nosokomialen Infektionen 2004 (snip04)]. Swissnoso Bull.2005;12:1-8. German.
  17. Swiss Federal Office of Public Health (FOPH). Gesundheit2020 - Health2020 - a comprehensive health care strategy. Liebefeld: FOPH; 2013. Available from: https://www.bag.admin.ch/bag/en/home/strategie-und-politik/gesundheit-2020/eine-umfassende-strategie-fuer-das-gesundheitswesen.html
  18. Swiss Federal Office of Public Health (FOPH). Report on the national strategy for the monitoring, prevention and control of healthcare-associated infections (NOSO strategy). Liebefeld: FOPH; 2016. Available from: https://www.bag.admin.ch/bag/en/home/das-bag/publikationen/broschueren/publikationen-uebertragbare-krankheiten/publikation-nationale-strategie-noso.html
  19. Metsini A, Vazquez M, Sommerstein R, Marschall J, Voide C, Troillet N, et al. Point prevalence of healthcare-associated infections and antibiotic use in three large Swiss acute-care hospitals. Swiss Med Wkly. 2018;148:w14617. PMID: 29698542 
  20. Behnke M, Aghdassi SJ, Hansen S, Diaz LAP, Gastmeier P, Piening B. The prevalence of nosocomial infection and antibiotic use in German hospitals. Dtsch Arztebl Int. 2017;114(50):851-7.  https://doi.org/10.3238/arztebl.2017.0851  PMID: 29271343 
  21. McCabe WR, Jackson GG. Gram-negative bacteremia. I. Etiology and ecology. Arch Intern Med. 1962;110(6):847-53.  https://doi.org/10.1001/archinte.1962.03620240029006 
  22. National Healthcare Safety Network (NHSN). Surgical site infection (SSI) event. Atlanta: Centers for Disease Control and Prevention. [Accessed 12 Feb 2019]. Available from: https://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf
  23. 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 
  24. Swissnoso. Participant manual for the module Intervention for the prevention of postoperative wound infections. [Teilnehmerhandbuch für das Modul Intervention zur Prävention von postoperativen Wundinfektionen]. Bern: Swissnoso; 2018. German. Available from: https://www.swissnoso.ch/fileadmin/module/ssi_intervention/Dokumente_D/1_Handbuch/180918_Handbuch_SSI_Intervention_de.pdf
  25. Sax H. A Swiss invention becomes a global success: but what about Switzerland? [Eine Schweizer Erfindung macht Weltkarriere: aber wo bleibt die Schweiz?]. Swissnoso Bull.2010;16:1. German.
  26. Pittet D, Donaldson L. Clean Care is Safer Care: the first global challenge of the WHO World Alliance for Patient Safety. Infect Control Hosp Epidemiol. 2005;26(11):891-4.  https://doi.org/10.1086/502513  PMID: 16320985 
  27. Allegranzi B, Storr J, Dziekan G, Leotsakos A, Donaldson L, Pittet D. The first global patient safety challenge "Clean Care is Safer Care": from launch to current progress and achievements. J Hosp Infect. 2007;65(Suppl 2):115-23.  https://doi.org/10.1016/S0195-6701(07)60027-9  PMID: 17540254 
  28. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014;370(13):1198-208.  https://doi.org/10.1056/NEJMoa1306801  PMID: 24670166 
  29. Doerken S, Mandel M, Zingg W, Wolkewitz M. Use of prevalence data to study sepsis incidence and mortality in intensive care units. Lancet Infect Dis. 2018;18(3):252.  https://doi.org/10.1016/S1473-3099(18)30081-1  PMID: 29485090 
  30. Swiss Federal Office of Public Health (FOPH). Strategy on antibiotic resistance (StAR). Liebefeld: FOPH; 2015.Available from: https://www.bag.admin.ch/bag/en/home/das-bag/publikationen/broschueren/publikationen-uebertragbare-krankheiten/strategie-anbitiotikaresistenzen-schweiz.html
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