Trends in Healthcare-Associated Infections Prevalence and Risk Factors: Repeated Point Prevalence Survey in a Milan...

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Antimicrobial Stewardship

Background:

• Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose substantial challenges in tertiary care.
• Repeated point prevalence surveys (PPSs) are valuable for monitoring trends and informing infection prevention efforts.

Purpose of the Study:

• To analyze trends in HAI prevalence, microbiological characteristics, AMR patterns, and associated risk factors.
• To provide data for refining infection prevention strategies and hospital policies.

Main Methods:

• Four annual cross-sectional point prevalence surveys (PPSs) were conducted from 2022 to 2025.
• Standardized European Centre for Disease Prevention and Control (ECDC) protocol and systematic medical record review were utilized.
• Multivariable logistic regression identified independent risk factors for HAI.

Main Results:

• Overall HAI prevalence was 11.3%, with highest rates in intensive care units.
• Invasive device exposure, particularly central venous and urinary catheters, was the strongest predictor of HAI.
• Common pathogens included Gram-positive cocci and Enterobacterales, with significant resistance noted in Klebsiella pneumoniae and Acinetobacter baumannii.

Conclusions:

• A persistently high burden of HAIs, driven by invasive devices and resistant pathogens, was observed.
• Hospital-wide device stewardship and integrated surveillance are essential for effective prevention and antimicrobial policy refinement.
• Repeated PPSs are critical for adapting local responses to evolving resistance profiles.