Prevalence of gastrointestinal system infections acquired in Provincial Hospital in 2004-2013

Gastrointestinal system infection (GI) is an infection which is frequently acquired in health- care settings. In Poland, there are limited data on the distribution of gastrointestinal system infections in the epidemiology of healthcare-associated infections (HAIs). Therefore, a study was initiated with the objective to assess the prevalence and distribution of healthcare-associated gastrointestinal system infections in patients hospitalized in St. Lukas Provincial Hospital in Tarnów.

Data of 297,545 patients hospitalized in 2004-2013 were subject to analysis. Standard epidemiological methods and unified definitions of healthcare-associated infections issued by the European Centre for Disease Prevention and Control (ECDC) were employed in the analysis.

A total of 944 healthcare-associated gastrointestinal system infections were indentified in the material analyzed. In a 10-year observation of HAI prevalence, GIs predominated over other HAIs registered in St. Lukas Provincial Hospital in Tarnów. Cumulative incidence rate (CIR) and incidence density rate (IDR) for GIs were 0.35% and 0.57/1,000 person-days, respectively. Infections with Clostridium difficile (GI-CDI), also referred to as C. difficile-associated diarrhoea (CDAD) were diagnosed in 301 patients. For GI-CDI, CIR and IDR were 0.11% and 0.18/1,000 person-days, respectively. Gastroenteritis excluding CDI (GI-GE) was identified in 643 patients with CIR and IDR amounting to 0.24% and 0.39/1,000 person-days, respectively. Gastroenteritis of rotavirus (CIR - 0.11% and IDR - 0.18/1,000), adenovirus (CIR - 0.01% and IDR - 0.02/1,000) and norovirus (CIR - 0.01% and IDR - 0.01/1,000) etiology was identified in 292, 32 and 17 patients, respectively. The highest number of infections was reported in paediatric ward, i.e. 307 persons (32.5%) (CIR - 1.84% and IDR - 2.79/1,000) and internal medicine and nephrology ward - 202 infections (21.4%) (CIR - 1.47% and IDR - 1.66/1,000).

A 10-year observation of healthcare-associated infections showed a change in the distribution of HAIs. In recent years, GIs predominated over all infections acquired in healthcare settings. The most prevalent etiological agent identified was Clostridium difficile.