title: Hospital-acquired infections and leading pathogens detected in a regional university adult acute-care hospital in Genoa, Liguria, Italy: results from a prevalence study.
abstract: BACKGROUND
  A prevalence study aimed to update the epidemiological scenario of Hospital-Acquired Infections (HAI) was performed at the San Martino University Hospital of Genoa, the Regional Reference Adult-care Center in Liguria, Italy, with more than 1300 beds.
  
  
  METHODS
  The investigation was performed in all the wards, except the Psychiatric Units, between 19th March and 6Ih April, 2007, using a one-day monitoring system for each ward. International standardized criteria and definitions for the surveillance of HAI were used for the collection of data, which were recorded in specific software for subsequent consolidation, analysis and quality control.
  
  
  RESULTS
  The hospital infection control staff actively monitored 912 inpatients: a total of 84 HAI among 72 patients were diagnosed, with an overall prevalence of infections and affected cases of 9.2% (95% CI: 7.3-11.1) and 7.9% (95% CI: 6.1-9.7), respectively. Urinary Tract Infections (UTI) (30.9%), Respiratory Tract Infections (RTI) (28.6%) and Blood Stream Infections (BSI) (21.4%) were found to be the most frequent infections. As expected, both specific prevalence and localization of HAI varied considerably between wards, with the highest values recorded in Intensive Care Units (ICU) and in Functional Rehabilitation wards. RTI (26.3%) and BSI (13.2%) were found primarily represented in ICU, while the highest values of UTI (13.3%) were registered in Functional Rehabilitation Units. Enterococcus spp. (16.8%), Candida spp. (14%), Pseudomonas spp. (12.2), Staphylococcus aureus (10.7%), Escherichia coli (10.3%) and Coagulase-negative staphylococci (CNS) (9.3%) were the most frequent pathogens isolated. The overall rate of administration of antibiotics was 55.3% and penicillin (26.7%), cephalosporins (22.8%) and fluoroquinolones (17.9%) were found to be the leading antibacterial administered.
  
  
  CONCLUSIONS
  Results of the present study have been, and are currently, used for orientating surveillance and control hospital policies, planning activities according to a rational and evidence-based approach.
authors.affiliation: Department of Health Sciences, Section of Hygiene and Preventive Medicine, University of Genoa and San Martino University Hospital of Genoa, Italy. durando@unige.it
authors.forename: P
authors.initials: P
authors.lastname: Durando
authors.forename: M
authors.initials: M
authors.lastname: Bassetti
authors.forename: G
authors.initials: G
authors.lastname: Orengo
authors.forename: P
authors.initials: P
authors.lastname: Crimi
authors.forename: A
authors.initials: A
authors.lastname: Battistini
authors.forename: G
authors.initials: G
authors.lastname: Tiberio
authors.forename: D
authors.initials: D
authors.lastname: Bellina
authors.forename: A
authors.initials: A
authors.lastname: Talamini
authors.forename: F
authors.initials: F
authors.lastname: Dodi
authors.forename: F
authors.initials: F
authors.lastname: Ansaldi
authors.forename: C
authors.initials: C
authors.lastname: Alicino
authors.forename: R
authors.initials: R
authors.lastname: Iudici
authors.forename: L
authors.initials: L
authors.lastname: Sticchi
authors.forename: D
authors.initials: D
authors.lastname: De Florentiis
authors.forename: C
authors.initials: C
authors.lastname: Viscoli
authors.forename: G
authors.initials: G
authors.lastname: Icardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000458:organization & administration*; D007558:Italy; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology; D015995:Prevalence; D018805:Sepsis / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology; D055815:Young Adult