Burden of healthcare-associated infections in China: results of the 2015 point prevalence survey in Dong Guan City.
BACKGROUND
Healthcare-associated infections (HCAIs) are a major health threat. There are few data about HCAI and antibiotic use in the People's Republic of China in the English literature.


OBJECTIVE
To describe and discuss the prevalence of HCAI and antibiotic use from the 2015 point prevalence survey (PPS) in Dong Guan City.


METHODS
In 2015, the Dong Guan (City) Nosocomial Infection Control and Quality Improvement Centre organized its yearly PPS in the secondary and tertiary care hospitals of Dong Guan City. The survey was performed on one single calendar day.


RESULTS
Thirty-seven secondary and 14 tertiary care hospitals assessed 9679 and 11,641 patients, respectively. A total of 616 patients had 681 HCAIs. The pooled HCAI prevalence (95% confidence interval) in secondary care, tertiary care, and all hospitals together was 2.3% (2.0-2.6), 3.4% (3.0-3.7), and 2.9% (2.6-3.1), respectively. Lower respiratory tract infection (LRTI), urinary tract infection (UTI), surgical site infection (SSI), and bloodstream infection together accounted for 73.1% of HCAIs. LRTI was the most frequently diagnosed HCAI (35.5%), followed by UTI (17.0%), and SSI (15.1%). Gram-negative bacteria were most frequently isolated (68.1%), followed by Gram-positive bacteria (19.3%), and fungi (10.9%). Escherichia coli was the most frequent pathogen (14.8%), and Acinetobacter baumannii accounted for 10.9%. A total of 34.8% of the patients received one or more antimicrobials.


CONCLUSIONS
The pooled prevalence is in the range of other recent Chinese studies, but lower compared to previous reports in Europe, and the USA. The use of antimicrobials for therapeutic purposes is similar to that in Europe, but lower than previous Chinese reports, and lower than in the USA.
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Department of Infection Control, Dong Guan Hospital of Traditional Chinese Medicine, Dong Guan City, Guang Dong Province, China; Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
J
J
Wang
Department Infection Control, Dong Guan Tung Wah Hospital, Dong Guan City, Guang Dong Province, China; Dongguan Nosocomial Infection Control and Quality Improvement Centre, Dong Guan City, Guang Dong Province, China.
J
J
Hu
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
S
S
Harbarth
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
D
D
Pittet
Department Infection Control, Dong Guan Tung Wah Hospital, Dong Guan City, Guang Dong Province, China; Dongguan Nosocomial Infection Control and Quality Improvement Centre, Dong Guan City, Guang Dong Province, China.
M
M
Zhou
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Imperial College London, London, UK. Electronic address: walter.zingg@hcuge.ch.
W
W
Zingg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D005260:Female; D005658:Fungi / Q000145:classification / Q000302:isolation & purification*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D063728:Secondary Care Centers; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult
Antibiotic use; China; Dong Guan City; Healthcare-associated infection; Point prevalence survey