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. 2023 Aug 23:6:100421.
doi: 10.1016/j.puhip.2023.100421. eCollection 2023 Dec.

Implementation of a centralized, web-based surveillance for healthcare associated infections among residents of long-term care facilities in Italy

Costanza Vicentini  1 , Antonino Russotto  1 , Stefano Bazzolo  2 , Edoardo Rolfini  1 , Valentina Blengini  1 , Dario Gamba  1 , Antonella Agodi  3 , Martina Barchitta  3 , Stefania Bellio  4 , Elisa Fabbri  5 , Silvia Forni  6 , Enrico Ricchizzi  5 , Giancarlo Ripabelli  7 , Camilla Sticchi  8 , Fortunato Paolo D'Ancona  9 , Carla Maria Zotti  1 ; working group “HALT pilota 2022”
Affiliations

Implementation of a centralized, web-based surveillance for healthcare associated infections among residents of long-term care facilities in Italy

Costanza Vicentini et al. Public Health Pract (Oxf). .

Abstract

Objective: The Italian National Action Plan to contrast AMR identified among its objectives the development and implementation of a national Healthcare-Associated Infection (HAI) surveillance system based on European Centre for Disease Prevention and Control (ECDC) indications, through point prevalence surveys (PPS) of HAIs and antibiotic use in acute-care hospitals and long-term care facilities (LTCFs). We aimed to assess feasibility and appropriateness of proposed tools for a national surveillance system of HAIs and antibiotic use in LTCFs.

Study design: Point prevalence survey.

Methods: A pilot PPS was conducted between May-June 2022, among 15 LTCFs of 7 Italian regions. Data were collected in a single day in each LTCF, at the LTCF, ward, and resident levels, using a web-based data collection tool developed ad hoc. Data collector teams of each facility were invited to complete a questionnaire investigating opinions on the proposed tools.

Results: Among 1025 included residents, the prevalence of residents with at least one HAI was 2.5% (95% CI 1.7%-3.7%) considering all HAIs and 2.2% (95% CI 1.3%-3%) without considering SARS-CoV-2 infections. The prevalence of antimicrobial use was 3% (95% CI 0.2%-4.3%). Overall, most respondents were satisfied with the web-based software, training and protocol, even though some difficulties were reported.

Conclusions: A national surveillance network was established, which will facilitate future surveillance efforts. Further studies are necessary to evaluate the impact of the pandemic on HAI transmission and antibiotic use in LTCFs.

Keywords: Healthcare associated infections; Italy; Long term care facilities; Nursing homes; Surveillance.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Number of long-term care facilities participating in the LTCF PPS survey by regions, Italy, May–June 2022 (N = 15).
Fig. 2
Fig. 2
Demographic and clinical characteristics of residents with an active healthcare-associated infection (HAI) and/or receiving antibiotic therapy on the day of the survey (N = 37). Legend for Fig. 2: Box plots depicting median and interquartile range of the distribution of each variable. The X indicates the mean for each variable.
Fig. 3
Fig. 3
Risk factors for healthcare associated infections (HAIs) among residents with an active healthcare-associated infection (HAI) and/or receiving antibiotic therapy on the day of the survey (N = 37).
Fig. 4
Fig. 4
Healthcare associated infection (HAI) prevalence plotted against prevalence of residents receiving at least one antibiotic (facility-level data, N = 15).
See this image and copyright information in PMC

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