Risk factors for healthcare-associated infection in light of two years of experience with the ECDC point prevalence survey of healthcare-associated infection and antimicrobial use in Poland.
BACKGROUND
Healthcare-associated infection (HAI) and antimicrobial resistance are two of the most important threats in contemporary medicine. The aim of this study was to evaluate independent risk factors associated with higher prevalence of HAI in a population of patients hospitalized in acute care hospitals in Poland.


METHODS
This study was conducted in accordance with the protocol of the European Centre for Disease Prevention and Control (ECDC) point prevalence survey of HAI and antimicrobial use. Data for 16,598 patients were collected from 50 hospitals. Independent risk factors assessed included: hospital size and type; consumption of alcohol hand rub; isolation capacity; number of beds per full-time-equivalent (FTE) infection control doctor/nurse; sex; age; hospitalization specialty; exposure to invasive procedures; and McCabe score.


RESULTS
The highest prevalence of HAI was observed in large and teaching hospitals (6.7% and 7.4%, respectively), in children aged less than one (13.3%) and among males (7.2%). With regard to invasive procedures, the strongest association was observed for central venous catheterization (30.2%), intubation (41.6%) and urinary catheterization (17.5%). The highest prevalence of HAI was observed among patients in intensive care units (adult 39.8%, paediatric 30.8%). The lowest prevalence of HAI was observed in hospitals with one FTE infection control nurse per <200 beds (4.1%).


CONCLUSIONS
A high prevalence of HAI combined with high exposure to risk factors among patients in paediatric and adult ICUs should result in the introduction of an HAI prevention programme across Poland.
Department of Microbiology, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland; Dr A. Jurasz University Hospital, Bydgoszcz, Poland. Electronic address: deptul@o2.pl.
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Deptuła
Anaesthesiology and Intensive Care Unit, Vital Medic Private Hospital in Kluczbork, Poland.
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Trejnowska
Department of Infection Control, Poznan University Hospital Przemienienia Panskiego, Poznan, Poland.
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Ozorowski
Division of Microbiology and Infection Prevention, National Medicines Institute, Warsaw, Poland.
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Hryniewicz
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult
D000890:Anti-Infective Agents
ECDC point prevalence survey; Healthcare-associated infection; Point prevalence survey; Risk factors