The Incidence of Healthcare-Associated Infections, Their Clinical Forms, and Microbiological Agents in Intensive Care Units in Southern Poland in a Multicentre Study from 2016 to 2019.

INTRODUCTION: Healthcare-associated infections (HAIs) are a serious problem of modern medicine. Patients hospitalized in intensive care units (ICUs) develop HAI significantly more often than patients in other hospital units. MATERIALS AND METHODS: Analysis involved HAIs from three ICUs in southern Poland. The study was conducted in 2016-2019 on the basis of methodology recommended by the Healthcare-Associated Infections Surveillance Network (HAI-Net) and European Centre for Disease Prevention and Control (ECDC). The objective was to analyse HAIs, their clinical forms, and microbiological agents. RESULTS: The study included 3028 patients hospitalized for 26,558 person-days (pds) in ICU. A total of 540 HAIs were detected; incidence per 100 hospitalizations was 17.8%, incidence density per 1000 pds was 20.3. The mortality of patients with HAI was 16%, and in Clostridioidesdifficile infection (CDI), the mortality was 28%. The most common clinical form of HAI was bloodstream infection (BSI): 209 cases (incidence rate 6.9%), followed by pneumonia (PN): 131 (incidence rate 4.3%), and urinary tract infection (UTI): 110 cases (incidence rate 3.6%). The most frequently isolated bacteria were Klebsiella pneumoniae 16.4%, Acinetobacter baumannii 14.4%, Staphylococcus aureus 11.8%, and Escherichia coli 11.4%. CONCLUSIONS: A two-fold higher incidence rate of BSI was detected compared to the average incidence in European countries. BSI of unknown source (BSI-UNK) was predominant. K. pneumoniae and A. baumannii bacteria were the most often isolated microorganisms causing HAI. Infection control based on incidence rate for each type of infection is necessary in ICU to assess the epidemiological situation.

Incidence of healthcare-associated gastroenteritis in children hospitalized on paediatric ward in provincial hospital in 2007-2013.

OBJECTIVE: This article aimed at evaluating the incidence and distribution of healthcare-associated (HAI) gastroenteritis (GE) in patients hospitalized on paediatric ward in St. Lukas Provincial Hospital in Tarnów. INTRODUCTION: Gastroenteritis remains a common manifestation of healthcare-associated infections on paediatric wards. In Poland, there are limited data on the proportion of healthcare-associated GE in the epidemiology of healthcare-associated infections. It was decided to present the incidence and etiology of these infections in a 7 year study period. METHODS: For the purpose of this study, standard definitions of healthcare-associated infections issued by the European Centre for Disease Prevention and Control (ECDC) were adopted. Cumulative incidence rates and incidence density rates were calculated. RESULTS: A total of 11,966 records of children hospitalized in 2007-2013 were subject to analysis. In this period, 251 healthcare-associated gastroenteritis cases of viral etiology were identified. For these infections, cumulative incidence rate (CIR) and incidence density rate (IDR) were 2.11% and 3.37/1,000 person-days, respectively. GE was most frequently reported in children aged less than 2 years (average - 1.6, SD - 2.1). Average hospitalization of a child who was not diagnosed with healthcare-associated GE was 6.2 days while for GE case it amounted to 11.2 days. GE was equally present in girls and boys, i.e. 2.1%. Rotavirus-induced GE was the most commonly diagnosed (GE-RV - Rotavirus Gastroenteritis). Such virus was identified in 189 children (CIR - 1.58%, IDR - 2.51/1,000 person-days). Rotavirus GE was followed by concomitant infections with rotaviruses and adenoviruses. A total of 12 patients were diagnosed with such co-infection (CIR - 0.10%, IDR - 0.16/1,000 person-days). Infections caused by adenoviruses (GE-AV - Adenovirus Gastroenteritis) occurred in 7 patients (CIR - 0.06%, IDR - 0.09/1,000 person-days). For 43 (17%) children, etiological agents of healthcare-associated GE were not determined. SUMMARY: Rotaviruses were the most commonly identified etiological agents of healthcare-associated gastroenteritis on paediatric ward. Children aged less than 2 years were those most frequently affected.