Healthcare-associated infection in Italy: annual point-prevalence surveys, 2002-2004.

Objective: Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.

Design: Three point-prevalence surveys.

Methods: A total of 9,609 patients were surveyed.

Results: The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAI. Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.

Conclusion: Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.