Impact of hospital-related indicators on healthcare-associated infections and appropriateness of antimicrobial use according to a national dataset

被引：0

作者：

Garlasco, Jacopo ^{[1
,2
]}

D'Ambrosio, Angelo ^{[1
,4
]}

Vicentini, Costanza ^{[1
]}

Quattrocolo, Francesca ^{[1
,3
]}

Zotti, Carla Maria ^{[1
]}

机构：

[1] Univ Turin, Dept Publ Hlth Sci & Paediat, Turin, Italy

[2] Univ Verona, Dept Diagnost & Publ Hlth, Infect Dis Unit, Verona, Italy

[3] Supervisory Comm, Local Hlth Author Turin 5 ASL TO5, Turin, Italy

[4] European Ctr Dis Prevent & Control ECDC, Solna, Sweden

来源：

SCIENTIFIC REPORTS | 2024年 / 14卷 / 01期

关键词：

Healthcare-associated infections (HAIs); Point Prevalence Survey (PPS); Infection Prevention and Control (IPC); Antibiotic use; Antimicrobial stewardship; Surveillance indicators; VENTILATOR-ASSOCIATED PNEUMONIA; RESISTANT STAPHYLOCOCCUS-AUREUS; SURGICAL SITE INFECTIONS; BLOOD-STREAM INFECTIONS; INTENSIVE-CARE; SURVEILLANCE; REDUCTION; STEWARDSHIP; PREVENTION; PROGRAM;

D O I：

10.1038/s41598-024-82663-6

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Healthcare-associated infections (HAIs) represent a major threat in Europe. Infection prevention and control (IPC) measures are crucial to lower their occurrence, as well as antimicrobial stewardship to ensure appropriate use of antibiotics. Starting from Italian national data, this study aimed at: (i) describing IPC indicators, prevalence of HAIs, antimicrobial use and appropriateness of antibiotic use in Italy; (ii) estimating effects of IPC variables on HAI prevalence and on the proportion of antibiotics without specific reason. Based on data collected for Italy during the ECDC PPS-2 Point Prevalence Survey, descriptive statistics were computed at national and macro-regional level. Causal assumption-informed regression models were then built to estimate the impact of structural determinants, staffing parameters and IPC-related variables on HAI prevalence and percentage of antibiotic prescriptions with no reason detailed on medical records, after adjusting for relevant confounders. The Italian frame showed substantial heterogeneity for both outcomes between macro-regions. The percentage of single-bed rooms was the only structural determinant with significant, positive impact on HAI prevalence (OR = 0.91 for every + 5%, p < 0.001), while the prevalence of antimicrobial agents without specified reason was lower in the presence of one more IPC nurse (OR = 0.78, p < 0.001) or one more antibiotic stewardship consultant (OR = 0.67, p < 0.001) per 100 beds. Both outcomes were reduced in the presence of routinely filed IPC plans and reports (p < 0.001), HAI prevention measures (p < 0.001) and post-prescription review (p < 0.01). Our model confirmed the pivotal role of IPC measures and antimicrobial stewardship in contrasting HAIs and inappropriate antibiotic prescriptions. Post-prescription review appeared to be a valuable indicator of antimicrobial stewardship policies.

引用

页数：10