Background

Awareness of healthcare-associated infections (HAIs) and antimicrobial use in long-term care facilities (LTCFs) is increasing. In 2017, the third national point prevalence survey (PPS) was conducted in Italy as part of the third ‘Healthcare-Associated Infections in European Long-Term Care Facilities’ (HALT3) study.

Aim

To report the results of HALT3 and analyse the resident population of LTCFs, implementation of good practices, prevalence of infections and antimicrobial use.

Methods

The survey was designed as a PPS, carried out from April to June 2017. All residents who lived full-time in the institution were included. All facilities were asked to complete an institutional questionnaire, a ward list for all residents, and a resident questionnaire for those residents presenting with signs/symptoms of active infection and/or receiving an antimicrobial agent.

Findings

In total, 418 facilities took part in the study; 24,132 residents were eligible, and most were aged >85 years, disoriented and incontinent. The prevalence of HAIs was 3.9%, and 50% of the institutions reported that they had a professional trained in infection control on their staff. Only 26.4% of infections were confirmed by a microbiological sample, and 26.9% of the isolated micro-organisms were resistant to at least one antimicrobial class. In total, 1022 residents received at least one antimicrobial agent, and cephalosporins were prescribed most commonly.

Conclusion

The number of infection control and antimicrobial stewardship measures implemented was found to be considerably higher in this study compared with previous studies. This could lead to a reduction in the prevalence of HAIs, antimicrobial use and antimicrobial resistance. Further studies are needed to monitor these aspects.

中文翻译：

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长期护理机构（HALT3）中与医疗保健相关的感染和抗菌药物使用：意大利情况概述

背景

对与医疗保健相关的感染（HAI）和在长期护理机构（LTCF）中使用抗菌素的意识正在提高。2017年，作为第三次``欧洲长期护理机构中与卫生保健相关的感染''（HALT3）研究的一部分，在意大利进行了第三次全国点流行率调查（PPS）。

目的

报告HALT3的结果并分析LTCF的常住人口，良好实践的实施，感染的流行率和抗菌药物的使用。

方法

该调查被设计为PPS，于2017年4月至6月进行。其中包括所有在该机构全日制居住的居民。要求所有设施填写一份机构问卷，所有居民的病房清单，以及那些出现活动性感染迹象/症状和/或接受抗菌药物的居民的居民问卷。

发现

总共有418个设施参与了研究。有24,132名居民符合条件，并且大多数年龄超过85岁，迷失方向和大小便失禁。HAI的患病率为3.9％，有50％的机构报告说，他们拥有受过感染控制培训的专业人员。微生物样本仅确认了26.4％的感染，而分离的微生物中的26.9％对至少一种抗菌剂具有抗性。总共有1022名居民接受了至少一种抗菌剂，并且头孢菌素是最常用的处方药。

结论

与以前的研究相比，本研究发现实施的感染控制和抗菌管理措施数量要多得多。这可能导致HAIs的患病率，抗菌药物使用和抗菌药物耐药性降低。需要进一步研究以监测这些方面。