Point prevalence survey of healthcare associated infections in acute-care hospitals: a validation study in Italy, 2022
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Department of Public Health and Pediatrics, University of Turin, Italy
Unit of Infectious Diseases, ASO SS. Antonio e Biagio e Cesare Arrigo, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1928
Background and Objective: Italy has been participating since 2011 in European point prevalence surveys (PPS) of health-care associated infections (HAI) and antimicrobial use in acute-care hospitals, which are promoted by the European Centre for Disease Prevention and Control (ECDC) every five years. Growing evidence suggest the COVID-19 pandemic has increased awareness towards infectious diseases, and has led to improvements in infection prevention and control (IPC) practices. In this study, we investigated whether there was an improvement in terms of accuracy in recognizing HAIs comparing results of the current PPS (2022) with the previous PPS (2017) in Italy. Methods: The third Italian PPS was conducted in November 2022, applying ECDC definitions for HAIs and using the PPS protocol v.6.1. A validation survey was conducted in a hospital part of the representative sample. The study involved 50 patients belonging to geriatric, oncology, and psychiatry wards. Data for the validation study were collected during the same day as the primary PPS by an external validation team not involved in primary data collection, which was performed by hospital staff. Results: Both the primary and validation surveys identified the same 9 patients with at least an HAI, therefore sensitivity and specificity were 100%, which was an improvement compared to the previous PPS (sensitivity 80.6%, specificity 98.7%). HAI prevalence among included wards was 18% (95% confidence interval, CI 8.58-31.44). Excluding HAIs caused by SARS-CoV-2, a prevalence of 10% (95% CI 3.33-21.81) was measured. Conclusions: Results of this study suggest that there has in fact been an improvement in HAI detection accuracy, which could be due to staff being more aware of HAIs. However, not considering SARS-CoV-2 infections, the prevalence of HAIs in included wards was higher than the mean prevalence measured in the previous PPS.