Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;30(18):2400812.
doi: 10.2807/1560-7917.ES.2025.30.18.2400812.

Application of an updated methodology to estimate the burden of healthcare-associated infections in Italy, 2022

Costanza Vicentini  1 , Valerio Bordino  2 , Luca Bresciano  1 , Stefania Di Giacomo  1 , Fortunato D'Ancona  3 , Carla Maria Zotti  1 ; Italian PPS network  4
Collaborators, Affiliations

Application of an updated methodology to estimate the burden of healthcare-associated infections in Italy, 2022

Costanza Vicentini et al. Euro Surveill. 2025 May.

Abstract

BackgroundAccurate burden estimates are necessary to inform priority setting and rational resource allocation. Weighting prevalence inversely proportional to time-at-risk has been proposed as a solution for length-biased sampling, an important limitation affecting prevalence to incidence conversion for healthcare-associated infections (HAIs).AimThis study aimed to update Italian burden estimates by calculating HAI incidence, attributable mortality and disability-adjusted life years (DALYs). Further, we describe an adapted methodology for burden estimations.MethodsWe used data from the latest European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs, conducted in Italy in November 2022, to calculate the burden of five major HAIs at national level. We adapted the Burden of Communicable Diseases in Europe (BCoDE) methodology to include inverse probability weighting and compared results of naïve and weighted calculations.ResultsThe national sample included 18,397 patients. Overall, 564.8 DALYs per 100,000 general population resulted from weighted calculations (95% uncertainty interval (UI): 450.04-694.38), with an annual incidence of 685.42 cases per 100,000 general population (95% UI: 611.09-760.86) and 33.23 deaths per 100,000 general population per year (95% UI: 28.62-38.33). Concerning naïve estimates, overall 1,017.81 DALYs per 100,000 general population were calculated (95% UI: 855.16-1,190.59). In both calculations, healthcare-acquired bloodstream infections had the highest burden in terms of DALYs per 100,000 hospitalised and general population.ConclusionOur study confirmed the substantial burden of HAIs in Italy and renews the need to prioritise resources for infection prevention and control interventions.

Keywords: DALYs; Italy; Point prevalence survey; burden; healthcare associated infections.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Overview of the workflow for healthcare-associated infections burden estimations, Italy, 2022
Figure 2
Figure 2
Percentage of annual burden in disability-adjusted life years attributable to five types of healthcare-associated infections, based on naïve and inverse probability weighted calculations, Italy, 2022 (estimates based on the national representative sample, n = 18,397, and projected on the Italian population, n = 58,997,201)
Figure 3
Figure 3
Annual burden in disability-adjusted life years per 100,000 hospitalised population of five types of healthcare-associated infection, as sum of years lived with disability and years of life lost, based on naïve and inverse probability weighted calculations, Italy, 2022 (estimates based on the national representative sample, n = 18,397, and projected on the Italian population, n = 58,997,201)
See this image and copyright information in PMC

References

    1. Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank HP, Ducomble T, et al. Burden of six healthcare-associated infections on European population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study. PLoS Med. 2016;13(10):e1002150. 10.1371/journal.pmed.1002150 - DOI - PMC - PubMed
    1. Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-46. 10.1001/jamainternmed.2013.9763 - DOI - PubMed
    1. Kretzschmar M, Mangen MJJ, Pinheiro P, Jahn B, Fèvre EM, Longhi S, et al. New methodology for estimating the burden of infectious diseases in Europe. PLoS Med. 2012;9(4):e1001205. 10.1371/journal.pmed.1001205 - DOI - PMC - PubMed
    1. Colzani E, Cassini A, Lewandowski D, Mangen MJJ, Plass D, McDonald SA, et al. A software tool for estimation of burden of infectious diseases in Europe using incidence-based disability adjusted life years. PLoS One. 2017;12(1):e0170662. 10.1371/journal.pone.0170662 - DOI - PMC - PubMed
    1. Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro ML, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018;23(46):1800516. 10.2807/1560-7917.ES.2018.23.46.1800516 - DOI - PMC - PubMed

LinkOut - more resources