The most frequent hospital-acquired infections related to medical interventions in hospitals in Vojvodina province

Abstract

Infections associated with medical procedures, or hospital-acquired infections (HAIs), occur in all hospitals worldwide. An integrated infection-control program with HAI surveillance as its cornerstone can reduce the incidence of HAIs and contribute to economic benefits. The aim of this paper was to report the prevalence and epidemiological features of HAI in hospitals in Vojvodina, Serbia. The study population examined herein was compromised of all of the patients present in the ward at least 48 hours before the day of surveillance. It also included patients that were scheduled for discharge or transfer, and those temporarily absent from the ward for examinations or diagnostic procedures. Data were collected using uniform questionnaires, created by the scientific board of the study. Data from paper questionnaires were entered into a specially created electronic database and analyzed using standard statistical methods. A total of 2 435 patients were included in the study. The frequency of patients with HAI was 6.6% (95% CI: 5.6%-7.6%), and the prevalence of infection was 7.1% (95% CI: 6.1%-8.1%). HAI prevalence was significantly different depending on the ward, ranging from 1.7% in the gynecology department to 18.1% in intensive care departments. The most common type of HAI was pneumonia, representing 20.9% of all reported HAIs. The second most frequently reported type of HAI was surgical site infection (19.8%), followed by urinary tract infection (17.4%), gastro-intestinal infection (14.5%) and bloodstream infection (11.0%). The most commonly found microorganisms were Enterococcus spp. (14.5%), Klebsiella pneumoniae (14.5%), Acinetobacter spp. (13.7%), coagulase-negative Staphylococcus spp. (12.1%), Pseudomonas aeruginosa (10.5%) and Clostridium difficile (7.3%). The most frequently used antibiotics in therapy were third generation cephalosporins to which most of the isolates showed resistance. Although the consumption of carbapenems in this sample was only 8%, the registered carbapenem resistance in some bacteria indicates more frequent and longer use of carbapenems in hospitals with the side effect of selective pressure.