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Abstract：
BACKGROUND: Healthcare-Associated Infections (HAIs) are a global public health issue, representing a significant burden of disease that leads to prolonged hospital stays, inappropriate use of antimicrobial drugs, intricately linked to the development of resistant microorganisms, and higher costs for healthcare systems. The study aimed to measure the prevalence of HAIs, the use of antimicrobials, and assess healthcare- and patient-related risk factors, to help identify key intervention points for effectively reducing the burden of HAIs.
METHODS: A total of 28 acute care hospitals in the Lombardy region, Northern Italy, participated in the third European Point Prevalence Survey (PPS-3) coordinated by ECDC for the surveillance of HAIs in acute care hospitals (Protocol 6.0).
RESULTS: HAIs were detected in 1,259 (10.1%, 95% CI 9.6-10.7%) out of 12,412 enrolled patients. 1,385 HAIs were reported (1.1 HAIs per patient on average). The most common types of HAIs were bloodstream infections (262 cases, 18.9%), urinary tract infections (237, 17.1%), SARS-CoV-2 infections (236, 17.0%), pneumonia and lower respiratory tract infections (231, 16.7%), and surgical site infections (152, 11.0%). Excluding SARS-CoV-2 infections, the overall prevalence of HAIs was 8.4% (95% CI 7.9-8.9%). HAIs were significantly more frequent in patients hospitalized in smaller hospitals and in intensive care units (ICUs), among males, advanced age, severe clinical condition and in patients using invasive medical devices. Overall, 5,225 patients (42.1%, 95% CI 41.3-43.0%) received systemic antimicrobial therapy. According to the WHO\'s AWaRe classification, the Access group accounted for 32.7% of total antibiotic consumption, while Watch and Reserve classes accounted for 57.0% and 5.9% respectively. From a microbiological perspective, investigations were conducted on only 64% of the HAIs, showing, however, a significant pattern of antibiotic resistance.
CONCLUSIONS: The PPS-3 in Lombardy, involving data collection on HAIs and antimicrobial use in acute care hospitals, highlights the crucial need for a structured framework serving both as a valuable benchmark for individual hospitals and as a foundation to effectively channel interventions to the most critical areas, prioritizing future regional health policies to reduce the burden of HAIs.
METHODS: A total of 28 acute care hospitals in the Lombardy region, Northern Italy, participated in the third European Point Prevalence Survey (PPS-3) coordinated by ECDC for the surveillance of HAIs in acute care hospitals (Protocol 6.0).
RESULTS: HAIs were detected in 1,259 (10.1%, 95% CI 9.6-10.7%) out of 12,412 enrolled patients. 1,385 HAIs were reported (1.1 HAIs per patient on average). The most common types of HAIs were bloodstream infections (262 cases, 18.9%), urinary tract infections (237, 17.1%), SARS-CoV-2 infections (236, 17.0%), pneumonia and lower respiratory tract infections (231, 16.7%), and surgical site infections (152, 11.0%). Excluding SARS-CoV-2 infections, the overall prevalence of HAIs was 8.4% (95% CI 7.9-8.9%). HAIs were significantly more frequent in patients hospitalized in smaller hospitals and in intensive care units (ICUs), among males, advanced age, severe clinical condition and in patients using invasive medical devices. Overall, 5,225 patients (42.1%, 95% CI 41.3-43.0%) received systemic antimicrobial therapy. According to the WHO\'s AWaRe classification, the Access group accounted for 32.7% of total antibiotic consumption, while Watch and Reserve classes accounted for 57.0% and 5.9% respectively. From a microbiological perspective, investigations were conducted on only 64% of the HAIs, showing, however, a significant pattern of antibiotic resistance.
CONCLUSIONS: The PPS-3 in Lombardy, involving data collection on HAIs and antimicrobial use in acute care hospitals, highlights the crucial need for a structured framework serving both as a valuable benchmark for individual hospitals and as a foundation to effectively channel interventions to the most critical areas, prioritizing future regional health policies to reduce the burden of HAIs.
摘要：
背景：医疗保健相关感染（HAIs）是一个全球性的公共卫生问题，代表了导致住院时间延长的重大疾病负担，不当使用抗菌药物，与抗性微生物的发展有着错综复杂的联系，以及医疗保健系统的更高成本。这项研究旨在测量HAIs的患病率，抗菌药物的使用，并评估医疗保健和患者相关的风险因素，帮助确定有效减轻HAIs负担的关键干预点。
方法：伦巴第地区共有28家急性护理医院，意大利北部,参加了由ECDC协调的第三次欧洲点患病率调查（PPS-3），以监测急性护理医院的HAIs（方案6.0）。
结果：在1,259（10.1％，95%CI9.6-10.7%)在12,412名登记患者中。报告了1,385个HAIs（平均每位患者1.1个HAIs）。最常见的HAIs类型是血流感染（262例，18.9%），尿路感染（237，17.1%），SARS-CoV-2感染（236，17.0%），肺炎和下呼吸道感染（231，16.7%），和手术部位感染（152，11.0%）。排除SARS-CoV-2感染，HAIs的总体患病率为8.4%(95%CI7.9-8.9%).在小型医院和重症监护病房（ICU）住院的患者中，HAIs的发生率明显更高，在男性中，高龄,严重的临床状况和使用侵入性医疗设备的患者。总的来说,5,225例患者（42.1％，95%CI41.3-43.0%)接受全身抗菌治疗。根据世界卫生组织的AWARE分类，Access组占抗生素总消费量的32.7%，而观察和储备类别分别占57.0%和5.9%。从微生物的角度来看，仅对64%的医院进行了调查，显示,然而,抗生素耐药性的重要模式。
结论：伦巴第的PPS-3，涉及急性护理医院HAIs和抗菌药物使用的数据收集，强调了对结构化框架的关键需求，该框架既是个别医院的宝贵基准，又是有效地将干预措施引导到最关键领域的基础，优先考虑未来的区域卫生政策，以减轻HAIs的负担。
方法：伦巴第地区共有28家急性护理医院，意大利北部,参加了由ECDC协调的第三次欧洲点患病率调查（PPS-3），以监测急性护理医院的HAIs（方案6.0）。
结果：在1,259（10.1％，95%CI9.6-10.7%)在12,412名登记患者中。报告了1,385个HAIs（平均每位患者1.1个HAIs）。最常见的HAIs类型是血流感染（262例，18.9%），尿路感染（237，17.1%），SARS-CoV-2感染（236，17.0%），肺炎和下呼吸道感染（231，16.7%），和手术部位感染（152，11.0%）。排除SARS-CoV-2感染，HAIs的总体患病率为8.4%(95%CI7.9-8.9%).在小型医院和重症监护病房（ICU）住院的患者中，HAIs的发生率明显更高，在男性中，高龄,严重的临床状况和使用侵入性医疗设备的患者。总的来说,5,225例患者（42.1％，95%CI41.3-43.0%)接受全身抗菌治疗。根据世界卫生组织的AWARE分类，Access组占抗生素总消费量的32.7%，而观察和储备类别分别占57.0%和5.9%。从微生物的角度来看，仅对64%的医院进行了调查，显示,然而,抗生素耐药性的重要模式。
结论：伦巴第的PPS-3，涉及急性护理医院HAIs和抗菌药物使用的数据收集，强调了对结构化框架的关键需求，该框架既是个别医院的宝贵基准，又是有效地将干预措施引导到最关键领域的基础，优先考虑未来的区域卫生政策，以减轻HAIs的负担。
