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Assessing the Burden of Healthcare-Associated Infections through Prevalence Studies: What Is the Best Method?1

Published online by Cambridge University Press:  10 May 2016

Walter Zingg*
Affiliation:
Infection Control Program and World Health Organization Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Benedikt D. Huttner
Affiliation:
Infection Control Program and World Health Organization Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Hugo Sax
Affiliation:
Infection Control Program and World Health Organization Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland Present affiliation: Division of Infectious Diseases and Infection Control, University Hospital of Zurich and Faculty of Medicine, Zurich, Switzerland
Didier Pittet
Affiliation:
Infection Control Program and World Health Organization Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
*
Infection Control Program, University of Geneva Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland ([email protected]).

Abstract

Objective.

To explore differences in the prevalence of healthcare-associated infections (HAIs) according to survey methodology.

Design.

Repeated point and period prevalence survey strategies.

Setting.

University-affiliated primary and tertiary care center.

Methods.

Analysis of data collected from 2006 to 2012 from annual HAI prevalence surveys using definitions proposed by the US Centers for Disease Control and Prevention. The study design allowed the analysis of the same data in the format of a point or a period prevalence survey.

Results.

Pooled point and period HAI prevalence was 7.46% and 9.84% (+32%), respectively. This additional 32% was mainly attributable to infections of the lower respiratory tract (2.42% vs 3.20% [+32%]) and the urinary tract (1.76% vs 2.62% [+49%]). Differences in surgical site infections (1.02% vs 1.20% [+19%]) and bloodstream infections (0.76% vs 0.86% [+13%]) were smaller. HAI prevalence for the point and period methodology in acute and long-term care were 7.47% versus 9.38 (+26%) and 8.37% versus 11.89% (+42%), respectively. Differences were stable over time. Focusing on the 4 major HAIs (respiratory tract, urinary tract, surgical site, and bloodstream infections) misses one-quarter of all HAIs.

Conclusions.

More HAIs are identified by the period prevalence method, especially those of shorter duration (lower respiratory and urinary tract), which would make this method more suitable to be used in long-term care. Results of the 2 study methods cannot be benchmarked against each other.

Infect Control Hosp Epidemiol 2014;35(6):674–684

Type
Original Articles
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

Presented in part: 2nd International Conference on Prevention and Infection Control; Geneva, Switzerland; June 25–28, 2013 (Abstract P-222).

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