Open Access

Prevalence of and factors associated with healthcare-associated infections in Slovenian acute care hospitals: Results of the third national survey

Irena Klavs
Irena Klavs
, 
Mojca Serdt
Mojca Serdt
, 
Aleš Korošec
Aleš Korošec
, 
Tatjana Lejko Zupanc
Tatjana Lejko Zupanc
, 
Blaž Pečavar
Blaž Pečavar
 and 
   | Mar 26, 2019
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Article Category: Original scientific article
Published Online: Mar 26, 2019
Page range: 62 - 69
Received: Sep 14, 2018
Accepted: Mar 06, 2019
DOI: https://doi.org/10.2478/sjph-2019-0008
Keywords
© 2019 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Prevalence of exposures to indwelling devices on the day of the survey, overall and according to different ward specialties, Slovenian national healthcare-associated infection prevalence survey, 2017.

Intensive careGeneral medicineSurgeryGynaecology, obstetrics & neonatologyPaediatricsOther/mixedAll(95% CI)
Peripheral vascular catheter68.9%56.8%49.7%21.7%57.3%22.1%48.2%(46.9% - 49.5%)
Central vascular catheter74.0%6.9%9.6%0.2%7.1%5.2%9.4%(8.6% - 10.1%)
Urinary catheter81.1%20.9%18.5%6.8%1.1%13.7%19.1%(18.1% - 20.2%)
Intubation48.0%1.0%2.3%0.6%2.1%1.3%3.1%(2.7% - 3.6%)
Number of patients196219019975452815345743

Number and prevalence of different types of healthcare-associated infections (HAIs), overall and according to ward specialties, Slovenian national healthcare-associated infections prevalence survey, 2017.

Intensive careGeneral medicineSurgeryGynaecology, obstetrics & neonatologyPaediatricsOtherAll
NumberNumberNumberNumber
(prevalence)(prevalence)(prevalence)(prevalence)NumberNumberNumber
(prevalence)(prevalence)(prevalence)
Pneumoniae35 (17.9%)38 (1.7%)19 (1.0%)1 (0.2%)
Surgical site infections5 ( 2.6%)4 (0.2%)65 (3.3%)3 (0.6%)3 (1.1%)11 (2.1%)107 (1.9%)
Urinary tract infections6 ( 3.1%)41 (1.9%)15 (0.8%)1 (0.2%)0 (0.0%)7 (1.3%)84 (1.5%)
Systemic infections3 ( 1.5%)22 (1.0%)13 (0.7%)0 (0.0%)1 (0.4%)5 (0.9%)69 (1.2%)
Gastro-intestinal system infections2 ( 1.0%)13 (0.6%)4 (0.2%)0 (0.0%)0 (0.0%)2 (0.4%)40 (0.7%)
Bloodstream infections with CRI36 ( 3.1%)10 (0.5%)3 (0.2%)0 (0.0%)0 (0.0%)5 (0.9%)24 (0.4%)
Skin and soft tissue infections0 ( 0.0%)4 (0.2%)4 (0.2%)0 (0.0%)1 (0.4%)0 (0.0%)20 (0.3%)
Central nervous system infections1 ( 0.5%)3 (0.1%)3 (0.2%)0 (0.0%)0 (0.0%)2 (0.4%)10 (0.2%)
Eye, Ear, Nose or Mouth infection0 ( 0.0%)5 (0.2%)1 (0.1%)1 (0.2%)1 (0.4%)0 (0.0%)8 (0.1%)
Other lower respiratory tract infections4 ( 2.0%)3 (0.1%)0 (0.0%)0 (0.0%)0 (0.0%)1 (0.2%)8 (0.1%)
Bone and joint infections0 ( 0.0%)0 (0.0%)5 (0.3%)0 (0.0%)0 (0.0%)0 (0.0%)7 (0.1%)
Cardiovascular system infections0 ( 0.0%)1 (0.0%)4 (0.2%)0 (0.0%)0 (0.0%)1 (0.2%)6 (0.1%)
Catheter-related infections w/o BSIs0 ( 0.0%)2 (0.1%)1 (0.1%)0 (0.0%)0 (0.0%)0 (0.0%)5 (0.1%)
Reproductive tract infections0 ( 0.0%)0 (0.0%)0 (0.0%)2 (0.4%)0 (0.0%)0 (0.0%)3 (0.1%)
Specific neonatal infections4 ( 2.0%)0 (0.0%)0 (0.0%)8 (1.5%)0 (0.0%)0 (0.0%)2 (0.0%)
Patients with at least one HAIa60 (30.6%)127 (5.8%)134 (6.7%)16 (2.9%)4 (1.4%)0 (0.0%)16 (0.3%)
9 (3.2%)31 (5.8%)377 (6.6%)

Microorganisms identified in healthcare-associated infections (HAIs) overall and by most common types of HAIs, Slovenian national healthcare-associated infections prevalence survey, 2017.

Pneumonia/lower respiratory tract infectionsSurgical site infectionsUrinary tract infectionsBloodstream infectionsGastrointestinal tract infectionsAll HAIs
NumberNumberNumberNumberNumberNumber
Number of all HAIs11684693325409
Number of HAIs with microorganisms all5044502519214
Number of microorganisms8373602723301
Gram-positive cocci Staphylococcus aureus16 934 910 013 43094 30
Streptococcus spp.41273230
Coagulase-negative staphylococci1935023
Other gram-positive cocci2401111
Gram-negative cocci000000
Enterobacteriaceae382039116123
Escherichia coli56197240
Enterobacter spp.10742128
Klebsiella spp.11271124
Proteus spp.3350113
Other Enterobacteriaceae9241118
Non-fermenting gram-negative bacteria18670133
Pseudomonas aeruginosa9460121
Other non-Enterobacteriaceae9210012
Anaerobic bacilli08011222
Clostridium difficile00001212
Other anaerobes0801010
Other bacteria000000
Fungi11542027
Candida spp.9542025
Other fungi200002
Virus000012
Negative codes62401976189
Examination not done372460287
Not yet available/missing111196251
Sterile examination13531148
Microorganism not identified101013

Prevalence of healthcare-associated infections (HAIs) acquired during current hospitalisation according to patients’ characteristics, ward specialties, and exposure to extrinsic risks and results of univariate and multivariate analysis of association, Slovenian national healthcare-associated infections prevalence survey, 2017.

Univariate analyses (whole data)Univariate analyses (restricted data)Multivariate analyses (restricted data)
Prevalence of HAIsNumber of patients (base)Odds ratiop-value (95% CI)Odds ratiop-value (95% CI)Adjusted odds ratiop-value (95% CI)
Age
<50 years3.9%15881p<0.0011p<0.001
50–79 years7.7%30172.1(1.5-2.7)2.0(1.5-2.7)
≥80 years7.3%11381.9(1.4-2.7)1.9(1.4-2.7)
McCabe index
Non-fatal disease4.7%41431p<0.0011p<0.001
Ultimately fatal disease10.3%11282.3(1.8-2.9)2.3(1.8-2.9)
Rapidly fatal disease14.5%3943.4(2.5-4.7)3.3(2.4-4.6)
Surgery (during current hospitalisation)
No4.9%39041p<0.0011p<0.0011p<0.01
Yes10.2%18272.2(1.8-2.7)2.2(1.8-2.7)1.6(1.2-2.0)
Intubation
No5.8%55651p<0.0011p<0.001
Yes30.3%1787.1(5.0-9.9)7.1(5.0-9.9)
Central vascular catheter
No4.7%52021p<0.0011p<0.0011p<0.001
Yes24.8%5376.7(5.3-8.5)6.7(5.3-8.5)4.1(3.1-5.4)
Peripheral vascular catheter
No4.6%29671p<0.0011p<0.0011p<0.001
Yes8.7%27692.0(1.6-2.5)2.0(1.6-2.5)3.0(2.3-3.9)
Urinary catheter
No4.1%46401p<0.0011p<0.0011p<0.001
Yes16.8%10994.7(3.8-5.8)4.7(3.8-5.8)1.8(1.4-2.3)
Length of hospital staya:
≤3 days1.1%18921p<0.0011p<0.0011p<0.001
4-7 days3.1%14342.8(1.7-4.8)2.8(1.7-4.8)2.6(1.5-4.4)
8-14 days9.5%11539.3(5.8-14.9)9.3(5.8-14.9)9.4(5.8-15.2)
≥15 days16.1%126417.0(10.8-26.9)16.9(10.7-26.7)15.5(9.7-24.8)
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