Healthcare-associated infections in hospital settings: New perspectives and strategies for prevention and control
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Università degli Studi di Pavia Department of Public Health, Experimental and Forensic Medicine Italy
School of Medicine, Università Vita-Salute San Raffaele, Italy
Università Vita-Salute San Raffaele School of Medicine & ASPHER Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A973
Healthcare-associated infections (HAIs) are the most common and severe healthcare-associated complications and a major public health issue because of the impact on morbidity, mortality, and quality of life and of the economic burden on healthcare systems worldwide. Yet, most HAIs are preventable and can be reduced by up to 70% through effective Infection Prevention and Control (IPC) measures. New strategies and perspectives in IPC are needed to counteract antimicrobial resistance and reinforce HAIs prevention, through high-quality evidence-based care in the context of universal health coverage. This intensive workshop will explore innovative approaches through the implementation at the facility level of protocols, digital technologies and tools. It will be structured as follows. First, data on the prevalence study on HAIs and antibiotic use, conducted at Humanitas Mater Domini Hospital Castellanza (Italy) in April 2022, will be presented. The study followed the ECDC Point Prevalence Survey protocol and involved 103 patients. 26% of included patients had an infection, and 62% were undergoing antibiotic therapy. The tool allowed the identification of non-conformities and the improvement of HAIs management, through antibiotic use awareness and stewardship. Secondly, to explore the incidence and management of methicillin-resistant and methicillin-sensitive S. Aureus (MRSA and MSSA) infections, a prospective observational multicentre study conducted among patients undergoing elective arthroplasty surgery at the Clinical Institutes of Pavia and Vigevano (Italy) will be introduced. The analysis was performed between March and November 2022: out of 737 patients, 7 (0.9%) resulted positive for MRSA and 142 (19.3%) for MSSA. Early identification of MRSA/MSSA infections with active screening proved to be a reliable measure for targeted preventive antibiotic treatment in order to avoid surgical site infections. The third presentation will open up with an outbreak of Acinetobacter baumannii, and Carbapenem-resistant Klebsiella pneumoniae that occurred in April 2022 within the intensive care unit of IRCCS Fondazione Policlinico San Matteo, Pavia (Italy), affecting 9 patients. Thanks to the swift strategy provided by the Medical Directorate, which resulted in initiatives based on the specific biological characteristics of micro-organisms survival, the outbreak ended on May 29th. This experience shows the key role of standard precautions and infection prevention and control measures in providing high-quality care. The fourth panellist will talk about the implementation of a motivated request form for the prescription of antimicrobials through Electronic Health Records (EHR) in 2022 at the IRCCS Policlinico San Donato, San Donato Milanese (Italy). Reviewing 55 motivated requests for meropenem, daptomycin and caspofungin, we compared the delivered doses with the administrations on the EHR. Overall, 24 requests for 97,560 milligrams of drugs were delivered but not administered; € 2,016 were subsequently lost. The introduction of EHRs allowed direct monitoring of requests’ appropriateness. The workshop, bringing together experts with topic knowledge on IPC, will provide answers on how to design a culture for HAI prevention. In the end, we will engage in a fruitful discussion with the audience on the data presented and practical public health implications, exploring how they can inform critical policy debates addressing evidence-based prevention strategies.
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