HEALTHCARE-ASSOCIATED INFECTIONS (HAIs)
- Escherichia Coli. image Simulazioni al computer per progettazione di nuovi farmaci (Sharper night 2021) Università degli Studi di Cagliari – Dipartimento di Fisica
[Date of last update: october 2021]
Healthcare-associated infections, together with antimicrobial resistance, represent one of the major problems for public health and significantly affect the quality and safety of health care. Their impact on morbidity and mortality has been well described, including the economic burden on society [1, 4]
The World Health Organization lists HAIs as the most frequent adverse event during delivery of health services, with a progressing epidemiological trend and a significant clinical and economic impact with a consequent increase in direct and indirect costs, due to an extension of the length of hospital stay, long-term disability and mortality. [2]
The 2016-2017 Point Prevalence Survey of the ECDC reported that 8.9 million HAIs occur in European acute and long-term care facilities each year [3].
2,609,911 new cases of healthcare-associated infections occur each year in the European Union and the European Economic Area. The cumulative burden of the six HAIs was estimated at 501 disability-adjusted life years (DALYs) per 100,000 population, with over 90,000 deaths per year [4].
426,277 nosocomial infections caused by antimicrobial resistant microorganisms occur annually in the European Union. Attributable deaths due to antimicrobial resistant microorganisms were estimated at 33,110 per year. [5]
HAIs are potentially avoidable, reductions between 35% and 55% have been described if effective infection prevention and control (IPC) interventions are implemented [6, 7]. National and facility level improvements in IPC are critical to the successful containment of antimicrobial resistance and the prevention of HAIs, including outbreaks of highly communicable diseases through high-quality care in the context of universal health coverage . [8]
The extent and severity of the current situation cannot be resolved without a more centralized global approach, setting a minimum Gold standard for mandatory application of infection control measures, defining mandatory Curricula for infection control and antibiotics management in medical schools and defining appropriate indicators to monitor the implementation and effectiveness of interventions. [9]
Bibliographic references of the text
[1] Tartari E, Tomczyk S, PiresD, Zayed B, Coutinho Rehse AP, Kariyo P, et al. Implementationof the infection prevention andcontrol core components at the national level: a global situational analysis. J Hosp Infect.2021; 108:94–103. doi: 10.1016/j.jhin.2020.11.025
[2] World Health Organization. Report on theburden of endemichealth care-associated infection worldwide. Geneva: WHO;2011. Available at: http://apps.who.int/iris/handle/10665/80135
[3] Suetens, K. Latour, T. Kärki, E. Ricchizzi, P. Kinross, M.L. Moro, etal.Prevalence of healthcare-associated infections, estimated incidence and compositeantimicrobial resistance index in acute care hospitals and long-term carefacilities: results from two European point prevalence surveys, 2016 to 2017 Eurosurveillance, 23 (2018), pp. 1-18, 10.2807/1560-7917.ES.2018.23.46.1800516
[4] Cassini A., Plachouras D., Eckmanns T., AbuSin M., Blank H. P., Ducomble T., et al.Burden of six healthcare-associated infections on European populationhealth: estimating incidence-based disability-adjusted life years through apopulation prevalence-based modelling study PLoS Med, 13 (2016), pp. 1-16, 10.1371/journal.pmed.1002150
[5] Cassini A, Högberg LD, Plachouras D,Quattrocchi A, Hoxha A, Simonsen GS, Colomb-Cotinat M, Kretzschmar ME, Devleesschauwer B, CecchiniM, Ouakrim DA, Oliveira TC, Struelens MJ, Suetens C, Monnet DL; Burdenof AMR Collaborative Group. Attributable deaths and disability-adjustedlife-years caused by infections with antibiotic-resistant bacteria in the EUand the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019Jan;19(1):56-66. doi: 10.1016/S1473-3099(18)30605-4.
[6] Zingg W., Holmes A., Dettenkofer M.,Goetting T., Secci F., Clack L. Hospitalorganisation, management, and structure for prevention of health-care-associatedinfection: a systematic review andexpert consensus. Lancet Infect Dis.2015; 15:212–224. doi: 10.1016/S1473-3099(14)70854-0
[7] Schreiber PW, Sax H., Wolfensberger A.,Clack L., Kuster SP The preventableproportion of healthcare-associated infections 2005–2016: systematic review andmeta-analysis. Infect ControlHosp Epidemiol.2018; 39 :1277-1295. doi: 10.1017/ice.2018.183.
[8] Storr J, Twyman A, Zingg W, Damani N,Kilpatrick C, Reilly J, Price L, Egger M, Grayson ML, Kelley E, Allegranzi B;WHO Guidelines Development Group. Core components for effective infectionprevention and control programmes: new WHO evidence-based recommendations. Antimicrob Resist Infect Control.2017 Jan 10;6:6. doi: 10.1186/s13756-016-0149-9. PMID: 28078082; PMCID:PMC5223492.
[9] Tacconelli E, Pezzani MD. Public health burden of antimicrobial resistancein Europe. Lancet Infect Dis.2019 Jan;19(1):4-6. doi: 10.1016/S1473-3099(18)30648-0. Epub 2018 Nov 5. PMID: 30409682.
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Link
https://www.epicentro.iss.it/sorveglianza-ica/
https://www.epicentro.iss.it/antibiotico-resistenza/ar-iss
https://www.ahrq.gov/hai/index.html
https://www.who.int/publications/m/item/france-national-strategy-for-preventing-infections-and-antib...
Edited by Mariantonietta Pompeo
