Antonino Russotto, Claudia Gastaldo, Stefania Di Giacomo, Stefano Bazzolo, Dario Gamba, Carla Maria Zotti, Costanza Vicentini
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引用次数: 0
摘要
背景：医疗相关感染（HAIs）、抗生素使用（AMU）和抗菌药物耐药性（AMR）是衡量医疗质量和抗菌药物管理水平的重要指标。点流行率调查为优化感染预防和控制（IPC）策略提供了重要数据：目的：描述意大利皮埃蒙特各级医院和病房的 HAIs、AMU 和 AMR 的流行情况，强调与医院复杂性和患者护理特点的关联：数据包括医院特征、人口统计学、HAI、AMU、AMR 和临床特征。计算患病率比（PRs）以比较不同亚组的患病率：结果：HAI 的发生率为 8%，侵入性器械使用率增加是其中一个原因（PR 1.71，95% CI 1.64-1.78）。AMU发病率从2016年的42.8%降至40%。抗生素的使用趋势与 "意大利国家反AMR行动计划"（PNCAR）的目标一致，显示氟喹诺酮类药物的使用减少，阿莫西林处方增加。AMR趋势显示，耐沙西林金黄色葡萄球菌、耐头孢菌素大肠埃希菌和肺炎克雷伯菌的情况有所改善：研究结果突出表明，持续投资于 IPC 措施和强有力的抗菌药物管理计划至关重要。解决这些关键领域的问题对于减轻人感染性疾病的负担、促进抗生素的合理使用以及最终改善整个地区的患者护理和治疗效果至关重要。
Healthcare-associated infections and antimicrobial use: the third point prevalence survey on 42 acute care hospitals in Piedmont, Italy, 2022.
Background: Healthcare-associated infections (HAIs), antibiotic use (AMU) and antimicrobial resistance (AMR) are critical indicators of healthcare quality and antimicrobial stewardship. Point prevalence surveys provide essential data for optimizing infection prevention and control (IPC) strategies.
Objective: To describe the prevalence of HAIs, AMU and AMR across hospital levels and wards in Piedmont, Italy, highlighting associations with hospital complexity and patient care characteristics.
Methods: Data included hospital charatheristics, demographics, HAI, AMU, AMR, and clinical characteristics. Prevalence ratios (PRs) were calculated to compare rates across subgroups.
Results: The prevalence of HAIs was 8%, with increased invasive device usage contributed (PR 1.71, 95% CI 1.64-1.78). AMU prevalence decreased to 40% from 42.8% in 2016. Trends in antibiotic use aligned with the "Italian National Action Plan to contrast AMR" (PNCAR) goals, showing reduced fluoroquinolone use and increased amoxicillin prescriptions. AMR trends showed improvements in oxacillin-resistant Staphylococcus aureus and cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae.
Discussion and conclusion: The results highlight the critical importance of sustained investment in IPC measures and robust antimicrobial stewardship programs. Addressing these key areas will be essential to mitigating the burden of HAIs, promoting the judicious use of antibiotics, and ultimately enhancing patient care and outcomes across the region.
期刊介绍：
AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)
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