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The increase in the use of antibiotics in the EU is also highlighted: 35.5% in 2022/2023 compared to 32% in 2016/2017
Every year 4.3 million patients hospitalized in the European Union contract at least one infection related to healthcare during your hospital stayso hygiene in hospitals still represents a challenge for countries in the European area, as revealed by the third point prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in acute care hospitals, coordinated by the European Center for Disease Prevention and Control (ECDC) in 2022-2023.
“Healthcare-associated infections pose a significant challenge to patient safety in hospitals across Europe. These recent figures highlight the urgent need for further action to mitigate this threat. Prioritizing health care policies and practices prevention and control of infections, as well as antimicrobials and improving surveillance, we can effectively combat the spread of these infections and protect the health of patients,” said the director of the ECDC, Dr. Andrea Ammonat a press conference this Monday.
The prevalence of patients with at least one HAI in the EU/EEA sample was 7.1% (country range 3.1% to 13.8%). The adjusted prevalence of patients with at least one HAI was estimated at 8%. After adjustment for a non-participating EU/EEA country (Denmark), a total of 93,305 patients with at least one HAI on any given day.
Respiratory tract infections with 29.3% of the total, including pneumonia (19%), Covid-19 (7%) and other lower respiratory tract infections (3.3%), followed by urinary tract infections (19.2%), surgical site infections (16.1%), bloodstream infections (11.9%) and gastrointestinal infections (9.5%), representing ‘C. difficile’ 62.1% of the latter and 5.9 percent of all HAIs. The kind of most frequent infection At the time of admission it was the isurgical site infection (25,7%).
The highest prevalence was recorded in intensive care patients, with 20.5%, compared to 6.4% for all other specialties combined. 16,948 microorganisms were reported in 13,875 (60.8%) HAIs.
The most frequently isolated microorganisms in HAIs were, in descending order, ‘Escherichia coli’ (12,7%), ‘Klebsiella spp’ (11,7%), ‘Enterococcus spp’ (10,0%), SARS-CoV-2 (9.5%), ‘S. aureus’ (9.0%), ‘C. difficult’ (8.0%), ‘P. aeruginosa’ (7.9%), ‘coagulase-negative staphylococci’ (5.8%), ‘Candida spp’ (4.7%), ‘Proteus spp’ (3.2%), ‘Acinetobacter spp’ (3 ,2%) and ‘Enterobacter spp’ (3.0%).
In this context, the ECDC highlights that at least 20% of HAIs can prevent through sustained and multifaceted programs. Thus, they emphasize that simple measures, such as hand hygiene and the distribution of disinfectants can significantly reduce the number of HAIs, although more complex interventions, such as having an adequate number of individual rooms and specialized control and prevention personnel, also play an important role.
However, the application of the control and prevention programs varies considerably from one European hospital to another, indicating the need to standardize practices and redouble efforts to improve compliance with the measures.
“Infection prevention control measures must be strengthened, starting with hand hygiene and the use of alcohol-based hand sanitizers. We must also ensure that each hospital has a sufficient number of individual rooms, as well as there will be capacity to isolate patients with multidrug-resistant bacteria, such as resistant pneumonia,” said the head of the Antimicrobial Resistance and Healthcare-Associated Infections Section – ECDC, Dominique Monnet.
Thus, he added that “of course, financial resources are also important for hiring personnel, but the compliance with guidelines and protocolsbehavior change should not cost much.
“Simple actions like hand hygiene can have a big impact, and we demonstrate this in the report by showing that the more, the higher the percentage of beds that have alcohol hand rubs at the bedside, the lower the risk of hand hygiene. So, yes, financing is important, money is important, but it is not everything,” he concluded.
INCREASE IN THE USE OF ANTIBIOTICS
On the other hand, the report reveals a increased use of antimicrobials compared to previous surveys. In the 2022-2023 PPS, 35.5% of patients received at least one antimicrobial agent, compared to 32.9% in the previous 2016-2017 PPS. On any given day in the EU and EEA, approximately 390,000 hospitalized patients receive at least one antimicrobial agent.
The survey detected 138,208 antimicrobials that were used in 103,169 patients, that is, 72.6% of the patients received an antimicrobial22.4% received of the and 5.4% received three or more. The weighted prevalence of antimicrobial use in the EU/EEA, taking into account the number of acute care beds occupied per country, was 32.4%. The estimated number of patients receiving at least one antimicrobial on any given day in acute care hospitals in the EU and EEA was 390,957 patients.
Antimicrobials were administered parenterally in 80.3% of cases, and the reason for antimicrobial use was documented in the patient’s medical history in 82.7% of cases.
The prevalence of antimicrobial use was the lowest in psychiatric patients (2.8%) and the highest alta in intensive care patients (59.5%). Antimicrobials were most frequently prescribed for the treatment of an infection (70.2%), a community-acquired infection (49.3%), a hospital-acquired infection (18.4%), and a long-term infection acquired (2.5%). The surgical prophylaxis It was the indication for 14.9% of prescriptions and was prolonged for more than one day in 48.3 percent of surgical prophylaxis prescriptions.
A special reason worry among experts is that one in three microorganisms detected in HAI were bacteria antibiotic resistant important, limiting treatment options for infected patients.
According to the report data, methicillin resistance was reported in 23.7% of S. aureus’ with known AST results. Vancomycin resistance was reported in 15.6% of enterococci isolates. Resistance to third generation cephalosporins third generation cephalosporin in 34.7% of all ‘Enterobacterales’ and the highest in ‘K. pneumoniae’, with 58.1%.
