Prevalence of healthcare-associated infections and antimicrobial use in Italian long-term care facilities: results from a national cross-sectional study (2022)
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Department of Public Health, University of Turin, Italy
Department of Environment, Land and Infrastructure Engineering (DIATI), Politecnico of Turin, Italy
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Italy
Azienda Zero, Veneto Region, Italy
Agenzia sanitaria e sociale regionale Emilia-Romagna, Emilia-Romagna Region, Italy
Agenzia Regionale di Sanità della Regione Toscana, Toscana Region, Italy
Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Italy
A.Li.Sa, Liguria Region, Italy
Italian National Institute of Health, Ministry of Health, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1924
Background and Objective: Healthcare-associated infections (HAIs) have a significant burden, particularly in long-term care facilities (LTCFs). Moreover, LTCFs were disproportionally affected by the COVID-19 pandemic. In preparation for the 2023 European Centre for Disease Prevention and Control (ECDC) “Point prevalence survey (PPS) of HAIs and antimicrobial use (AMU) in European long-term care facilities” (HALT), the Italian national coordinating team conducted a pilot PPS, with the Objective of establishing a regional surveillance network and assess the potential COVID-19 pandemic impact on HAIs. Methods: A PPS was conducted between May-June 2022. The protocol of this study is an updated version of the ECDC HALT-3. Seven Italian regions participated voluntarily enrolling a minimum of two LTCFs with at least 50 residents each, using convenience sampling. Data were collected in a single day in each LTCF, at the LTCF, ward, and resident levels. Resident data were collected for each resident with a HAI and/or AMU on the survey day. HAI and AMU prevalence were calculated as the mean number of residents with at least one HAI and/or AMU divided by the total number of eligible residents. Spearman’s correlational analysis was conducted between LTCF-level HAI and AMU prevalence. Results: 15 LTCFs with 1025 residents were included in the survey. HAI prevalence was 2.54% (95% CI 1.66%-3.69%) considering all HAIs and 1.56% (95% CI 0,89%-2.52%) not considering SARS-CoV-2 infections. The most frequent HAI was COVID-19 (30.3%). AMU prevalence was 3.02% (95% CI 0.21%-4,27%). The most prescribed agent was Ceftriaxone (48.4%). A positive correlation was found between LTCF-level HAI and AMU prevalence (Spearman’s ρ 0.395, p 0.0253). Conclusions: A national surveillance network was established. HAI prevalence was around one-third compared to 2017 Italian data, suggesting infection control activities could have improved following COVID-19 pandemic. Results will be useful to inform the 2023 ECDC HALT survey.