Prevalence of healthcare-associated infections in Polish adult intensive care units: summary data from the ECDC European Point Prevalence Survey of Hospital-associated Infections and Antimicrobial Use in Poland 2012-2014.

BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals. From this initial database, data for adult ICU patients (N=945) were filtered for further analyses. FINDINGS: HAIs were present in 370 patients (39%) and 430 HAI episodes were recorded. The most common HAIs were respiratory tract infections (45%), usually caused by Enterobacteriaceae and Gram-negative non-fermenters. The majority (87%) of these infections were likely to be device associated. Out of 61 cases of bloodstream infection, 51% were catheter associated. These bloodstream infections were mainly caused by coagulase-negative staphylococci. Among 57 cases of surgical site infection, 42% were classified as organ/space, 33% were classified as deep incisional, and 25% were classified as superficial. The predominant micro-organisms were Enterobacteriaceae and Staphylococcus aureus. Out of 50 cases of urinary tract infection, 96% were device associated. CONCLUSIONS: The prevalence of HAI among Polish adult ICU patients is higher than described in similar studies, but may be partially affected by methodological differences. The proportion of device-associated infections was very high, so there is an urgent need to introduce countrywide, targeted surveillance and prevention programmes.

Risk factors for healthcare-associated infection in light of two years of experience with the ECDC point prevalence survey of healthcare-associated infection and antimicrobial use in Poland.

BACKGROUND: Healthcare-associated infection (HAI) and antimicrobial resistance are two of the most important threats in contemporary medicine. The aim of this study was to evaluate independent risk factors associated with higher prevalence of HAI in a population of patients hospitalized in acute care hospitals in Poland. METHODS: This study was conducted in accordance with the protocol of the European Centre for Disease Prevention and Control (ECDC) point prevalence survey of HAI and antimicrobial use. Data for 16,598 patients were collected from 50 hospitals. Independent risk factors assessed included: hospital size and type; consumption of alcohol hand rub; isolation capacity; number of beds per full-time-equivalent (FTE) infection control doctor/nurse; sex; age; hospitalization specialty; exposure to invasive procedures; and McCabe score. FINDINGS: The highest prevalence of HAI was observed in large and teaching hospitals (6.7% and 7.4%, respectively), in children aged less than one (13.3%) and among males (7.2%). With regard to invasive procedures, the strongest association was observed for central venous catheterization (30.2%), intubation (41.6%) and urinary catheterization (17.5%). The highest prevalence of HAI was observed among patients in intensive care units (adult 39.8%, paediatric 30.8%). The lowest prevalence of HAI was observed in hospitals with one FTE infection control nurse per <200 beds (4.1%). CONCLUSION: A high prevalence of HAI combined with high exposure to risk factors among patients in paediatric and adult ICUs should result in the introduction of an HAI prevention programme across Poland.