title: Point prevalence surveys on healthcare acquired infections in medical and surgical wards of a teaching hospital in Rome.
abstract: Healthcare acquired infections (HAI) are an important cause of morbidity and mortality in hospitals worldwide. Aim of the study was to analyze nine years surveillance activity, carried out by point prevalence surveys from 2007 to 2015, in a 450-bed teaching hospital in Rome.
  
  
  
  Point prevalence surveys were carried out every year in the medical and surgical wards following the same methodology. In accordance with definitions used by the Centers for Disease Control, all infections occurred more than 48 hours after hospital admission were considered HAI, and included in the study. Baseline characteristics, clinical features, isolated pathogens (only for the period 2011-2015) and antimicrobial resistance were recorded.
  
  
  
  During the nine years point prevalence surveys a total 2,840 patients were enrolled. Overall 136 (4.79%) patients developed 180 (6.34%) HAI. The most frequent HAI were respiratory tract infections (RTI), which accounted for 35.0% of all HAI, followed by surgical site infections (SSI) 22.2%, urinary tract infections (UTI) 19.4%, bloodstream infections (BSI) 17.2%, and others 6.1%. HAI related to major invasive risk procedures were also evaluated. SSI/patients undergoing surgery 3.99%, UTI/ patients with urinary catheter 4.17% and BSI/patients with CVC 9.42%. Over one-half of all patients surveyed (1,532, 53.9%) were receiving antibiotics at the time of our study. Among them 892 (58.2%) for treatment, 641 (41.8%) for prophylaxis. In the latter group, 109 (17.0%) underwent extra-short term, 89 (13.9%) short term and 443 (69.1%) a long term prophylaxis. During the period 2011-2015 out of 110 HAI episodes 71 (64.5%) were confirmed microbiologically. In total 106 pathogens were isolates, Gram-negative bacteria (63.2%) were isolated more frequently than Gram-positive bacteria (28.3%).
  
  
  
  The overall HAI prevalence in our hospital was consistent with those reported in other studies in Italy. The study underlined the role of Gram-negative bacteria in HAI and the need for antimicrobial stewardship. It also provided useful baseline data for rational priorities in allocation of resources, for further infection control activities.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Marani
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, Sapienza University of Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Napoli
authors.affiliation: Health Direction, Azienda Ospedaliero Universitaria Sant'Andrea, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Berdini
authors.affiliation: Health Direction, Azienda Ospedaliero Universitaria Sant'Andrea, Sapienza University of Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Montesano
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ferretti
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Di Ninno
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Orioli
authors.affiliation: Health Direction, Azienda Ospedaliero Universitaria Sant'Andrea, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Luca
authors.affiliation: Health Direction, Azienda Ospedaliero Universitaria Sant'Andrea, Sapienza University of Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sommella
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, Sapienza University of Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tarsitani
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: G B
authors.initials: GB
authors.lastname: Orsi
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006784:Hospitals, Teaching; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D012384:Rome / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology
keywords: Healthcare acquired infection; Point prevalence survey; Surveillance