title: Temporal trends of healthcare associated infections and antimicrobial use in 2011-2013, observed with annual point prevalence surveys in Ferrara University Hospital, Italy.
abstract: Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and evaluate their effects. The objective of this study was to estimate the prevalence of HAIs and AM use, to describe types of infections, causative pathogens and to compare data collected through three PPSs in Ferrara University Hospital (FUH), repeated in 3 different years (2011-2013). The population-based sample consists of all patients admitted to every acute care and rehabilitation Department in a single day.
  
  
  
  ECDC Protocol and Form for PPS of HAI and AM use, Version 4.2, July 2011. Risk factor analysis was performed using logistic regression.
  
  
  
  1,239 patients were observed. Overall, HAI prevalence was 9.6%; prevalence was higher in Intensive Care Units; urinary tract infections were the most common HAIs in all 3 surveys; E.coli was the most common pathogen; AM use prevalence was 51.1%; AMs most frequently administered were fluoroquinolones, combinations of penicillins and third-generation cephalosporins. According to the regression model, urinary catheter (OR: 2.5) and invasive respiratory device (OR: 2.3) are significantly associated risk factors for HAIs (p < 0.05).
  
  
  
  PPSs are a sensitive and effective method of analysis. Yearly repetition is a useful way to maintain focus on the topic of HAIs and AM use, highlighting how changes in practices impact on the outcome of care and providing useful information to implement intervention programs targeted on specific issues.
authors.affiliation: Department of Hospital Hygiene & Healthcare Associated Infection Risk Management, Hospital Health Medical Management, Ferrara University Hospital, Ferrara, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Antonioli
authors.affiliation: Department of Hospital Hygiene & Healthcare Associated Infection Risk Management, Ferrara University Hospital, Ferrara, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Manzalini
authors.affiliation: Section of Public Health Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Stefanati
authors.affiliation: Postgraduate School of Hygiene and Preventive Medicine, Section of Public Health Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Bonato
authors.affiliation: Planning and Control Management, Ferrara University Hospital, Ferrara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Verzola
authors.affiliation: Postgraduate School of Hygiene and Preventive Medicine, Section of Public Health Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Formaglio
authors.affiliation: Section of Public Health Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gabutti
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents
keywords: Antimicrobial use; Healthcare-associated infections; Point prevalence surveys