Healthcare-associated infections in Japanese hospitals: results from a large-scale multicenter point-prevalence survey in Aichi, 2020.

Objective: Healthcare-associated infections (HAIs) pose significant challenges to healthcare systems worldwide. Epidemiological data are essential for effective HAI control; however, comprehensive information on HAIs in Japanese hospitals is limited. This study aimed to provide an overview of HAIs in Japanese hospitals.

Methods: A multicenter point-prevalence survey (PPS) was conducted in 27 hospitals across the Aichi Prefecture between February and July 2020. This study encompassed diverse hospital types, including community, university, and specialized hospitals. Information on the demographic data of the patients, underlying conditions, devices, HAIs, and causative organisms was collected.

Results: A total of 10,199 patients (male: 5,460) were included in this study. The median age of the patients was 73 (interquartile range [IQR]: 56-82) years, and the median length of hospital stay was 10 (IQR: 4-22) days. HAIs were present in 6.6% of patients, with pneumonia (1.83%), urinary tract infection (1.09%), and surgical site infection (SSI) (0.87%) being the most common. The prevalence of device-associated HAIs was 0.91%. Staphylococcus aureus (17.3%), Escherichia coli (17.1%), and Klebsiella pneumoniae (7.2%) were the primary pathogens in 433 organisms; 29.6% of the Enterobacterales identified showed resistance to third-generation cephalosporins. Pneumonia was the most prevalent HAI in small-to-large hospitals (1.69%-2.34%) and SSI, in extra-large hospitals (over 800 beds, 1.37%).

Conclusions: This study offers vital insights into the epidemiology of HAIs in hospitals in Japan. These findings underscore the need for national-level PPSs to capture broader epidemiological trends, particularly regarding healthcare challenges post-COVID-19.