A One-Day Pilot Point-Prevalence Survey of Healthcare-Associated Infections in Three Korean Hospitals: Risk Factors, Clinical Burden, and Implications for Nationwide Surveillance.
Jihwan Bang, Sung Ran Kim, Jeong Hwa Choi, Seung Jae Lee, Minsun Kang, Su Young Kim, Min Hee Cho, Eun Kyung Lee, Joon Young Song, Hyun Kyun Ki, Jaehun Jung, Jongtak Jung, Kyoung-Ho Song, Myoung Jin Shin, Eu Suk Kim
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Abstract
Background: Healthcare-associated infections (HAIs) remain a major cause of morbidity and mortality in hospitalized patients. We assessed the prevalence, clinical burden, and predictors of HAIs across multiple hospitals using point-prevalence and matched case-control designs.
Methods: A point-prevalence survey was conducted among all inpatients at three hospitals. For clinical burden analysis, HAI cases were matched to non-infected controls in a 1:3 ratio based on sex, age (±10 years), ward type, length of stay up to the survey date, clinical department, and surgical history (for surgical site infections). Propensity score matching was performed to generate 1:1 matched pairs. Multivariable logistic regression analyses were conducted to identify factors associated with HAI occurrence and to evaluate predictors of in-hospital and 30-day mortality.
Results: Among 2,226 patients, 119 had HAIs (prevalence, 5.35%). Recent microbiological culture testing, purulent discharge, documentation suggestive of infection in medical records, and fever were independently associated with HAIs in the propensity score-matched analysis. HAIs were also independently associated with increased in-hospital mortality, whereas the association with 30-day mortality was not statistically significant after adjustment for comorbidities and McCabe classification.
Conclusions: In this multicenter study, HAIs were associated with substantial clinical burden and increased mortality. Specific clinical indicators were strongly associated with HAI detection and may support surveillance strategies. These findings highlight the need for strengthened infection prevention and the integration of early identification systems into routine hospital surveillance.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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