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Multicenter Study
. 2021 Mar 6;10(1):47.
doi: 10.1186/s13756-021-00889-9.

A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: results from Serbian point prevalence survey, 2017

Vesna Šuljagić  1 , Milica Bajčetić  2 , Vesna Mioljević  3 , Gorana Dragovac  4   5 , Biljana Mijović  6   7 , Ivana Janićijević  8 , Zorana Đorđević  9 , Gordana Krtinić  10 , Violeta Rakić  11 , Ivana Ćirković  2 , Vladimir Nikolić  2 , Ljiljana Marković-Denić  2
Affiliations
Multicenter Study

A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: results from Serbian point prevalence survey, 2017

Vesna Šuljagić et al. Antimicrob Resist Infect Control. .

Abstract

Background: As the only non-European Union (EU) country, Serbia participated in a second point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use (AMU) organized by the European Centre for Disease Prevention and Control (ECDC) in the EU countries. Here, we aimed to estimate the prevalence of HAI and AMU in patients who had recently undergone a surgery and to compare risk profile, HAI rates, and AMU among surgical patients and non-surgical patients.

Methods: A national PPS was performed in 65 Serbian acute-care hospitals, in November 2017. In this paper, the data of 61 hospitals for adult acute-care were analyzed. To ensure the comparability of study design we used the Serbian translation of ECDC case definitions and ECDC PPS protocol. The trained infection control staff, led by a hospital coordinator, reviewed medical records to identify HAI active at the time of the survey and AMU. Only inpatients admitted to the ward before 8 a.m. on the day if the survey were included.

Results: A total of 12,478 patients from 61 hospitals for adult acute-care were eligible for inclusion in this study. Significantly higher proportions of surgical patients were female, belonged to the 60-to-79 age group, and were less severely ill. Also, extrinsic factors (invasive devices, hospitalization at the ICU, and prior antibiotics therapy) were more frequent in surgical patients. Prevalence of HAIs was higher among surgical patients (261/3626; 7.2%) than among non-surgical patients (258/8852; 2.9%) (p < 0.0001). The highest prevalence of all HAIs was noted in patients who had kidney transplantation (4/11; 36.4%), while SSIs were the most prevalent among patients who had peripheral vascular bypass surgery (3/15; 20.0%). Non-surgical patients received treatment for community-acquired infections in significantly higher proportion (2664/8852; 64.3) (p < 0.001). Surgical prophylaxis for more than 1 day was applied in 71.4% of surgical patients.

Conclusion: We have provided an insight into the burden of HAIs and AMU among Serbia acute-care hospitals, and highlighted several priority areas and targets for quality improvement.

Keywords: Antibiotics; Healthcare-associated infections; Point prevalence survey.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The geographical distribution of hospitals included in Serbian point prevalence survey
Fig. 2
Fig. 2
HAI prevalence among surgical and non-surgical patients according to the hospital size
Fig. 3
Fig. 3
The most often prescribed antibiotics to a surgical patients, Serbian PPS study, b non-surgical patients, Serbian PPS study
See this image and copyright information in PMC

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