Background: Healthcare-associated infections (HAIs) represent a significant burden among infectious diseases in Europe. The main aim of the present study, in the framework of the "Italian Nosocomial Infections Surveillance in Intensive Care Units (ICUs) network” (SPIN-UTI), was to investigate the impact of HAI on mortality and length of ICU stay Methods: Patient-based surveillance was conducted from the 79 participating ICUs during the period 2006-2015 using the European protocol for surveillance of HAIs in ICU (ECDC HAI-Net ICU protocol). A 30-day survival analysis was performed using the Kaplan-Meier function and comparisons among survival rates by the log-rank test. The risk of death was estimated using Cox regression analysis. Results: A total of 13103 patients were enrolled and the risk of HAI was 13.5 per 100 patients. Considering all patients, the risk of death did not change significantly. However, the risk of death was 2.5 significantly higher for infected patients compared with patients without infection. 30-day survival was significantly lower in infected patients (Log Rank - Mantel-Cox test, p<0,001). Patients who developed HAI during their hospitalization in the ICU, stayed in the unit over twice as long as patients without infections (17.9 vs. 8.0 days; p<0.001). After Cox regression analysis, SAPS II score above the median value, older age and emergency admission, were significantly associated to the risk of death. The presence of HAI was not significantly associated to the risk of death, although a significant contribution of antimicrobial resistance was shown. Conclusions: Surveillance of HAIs is essential to improve the quality of health services especially in ICUs. The study confirmed that HAIs are associated with higher mortality and a longer length of ICU-stay especially those due to antimicrobial resistant microorganisms, highlighting the need for effective preventive efforts to reduce the impact of HAIs and improve the quality of care.
Monitoring the quality of health services in ICU: ten years of the SPIN-UTI network HAI surveillance / Agodi, A.; Auxilia, F.; Barchitta, M.; Brusaferro, S.; D'Errico, Marcello Mario; Mt, Montagna; Pasquarella, C.; Tardivo, S.; Mura, I.. - ELETTRONICO. - (2017). (Intervento presentato al convegno 10th European Public Health Conference - Sustaining resilient and healthy communities tenutosi a Stockholm, Sweden nel 1-4 november 2017).
Monitoring the quality of health services in ICU: ten years of the SPIN-UTI network HAI surveillance
D'ERRICO, Marcello Mario;
2017-01-01
Abstract
Background: Healthcare-associated infections (HAIs) represent a significant burden among infectious diseases in Europe. The main aim of the present study, in the framework of the "Italian Nosocomial Infections Surveillance in Intensive Care Units (ICUs) network” (SPIN-UTI), was to investigate the impact of HAI on mortality and length of ICU stay Methods: Patient-based surveillance was conducted from the 79 participating ICUs during the period 2006-2015 using the European protocol for surveillance of HAIs in ICU (ECDC HAI-Net ICU protocol). A 30-day survival analysis was performed using the Kaplan-Meier function and comparisons among survival rates by the log-rank test. The risk of death was estimated using Cox regression analysis. Results: A total of 13103 patients were enrolled and the risk of HAI was 13.5 per 100 patients. Considering all patients, the risk of death did not change significantly. However, the risk of death was 2.5 significantly higher for infected patients compared with patients without infection. 30-day survival was significantly lower in infected patients (Log Rank - Mantel-Cox test, p<0,001). Patients who developed HAI during their hospitalization in the ICU, stayed in the unit over twice as long as patients without infections (17.9 vs. 8.0 days; p<0.001). After Cox regression analysis, SAPS II score above the median value, older age and emergency admission, were significantly associated to the risk of death. The presence of HAI was not significantly associated to the risk of death, although a significant contribution of antimicrobial resistance was shown. Conclusions: Surveillance of HAIs is essential to improve the quality of health services especially in ICUs. The study confirmed that HAIs are associated with higher mortality and a longer length of ICU-stay especially those due to antimicrobial resistant microorganisms, highlighting the need for effective preventive efforts to reduce the impact of HAIs and improve the quality of care.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
