A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece
Petros Ioannou,
Eirini Astrinaki,
Efsevia Vitsaxaki,
Emmanouil Bolikas,
Despoina Christofaki,
Apostolia Salvaraki,
Eirini Lagoudaki,
Eleni Ioannidou,
Stamatis Karakonstantis,
Stamatina Saplamidou,
Christos Cleovoulou,
Eleni Stamataki,
Stavroula Ilia,
Argyri Messaritaki,
Michaela Avdi,
Anthoula Chalkiadaki,
Styliani Papathanasaki,
Chrisanthi Markopoulou,
Evagelia Magouli,
Maria Moustaki,
Vasileia-Athina Kataxaki,
Panagiotis Skevakis,
Nikolaos Spernovasilis,
Georgios Chamilos,
Diamantis P. Kofteridis
Affiliations
Petros Ioannou
Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece
Eirini Astrinaki
Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
Efsevia Vitsaxaki
Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
Emmanouil Bolikas
Infection Control Committee, “Venizeleio-Pananeio” General Hospital of Heraklion, 71409 Heraklion, Greece
Despoina Christofaki
Infection Control Committee, Organic Unit of Agios Nikolaos, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72100 Agios Nikolaos, Greece
Apostolia Salvaraki
Infection Control Committee, General Hospital of Rethymno, 74132 Rethymno, Greece
Eirini Lagoudaki
Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
Eleni Ioannidou
Infection Control Committee, General Hospital of Rethymno, 74132 Rethymno, Greece
Stamatis Karakonstantis
Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece
Stamatina Saplamidou
Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
Christos Cleovoulou
Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
Eleni Stamataki
Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
Stavroula Ilia
Pediatric Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
Argyri Messaritaki
Office of Nursing Services, University Hospital of Heraklion, 71500 Heraklion, Greece
Michaela Avdi
Internal Medicine, General Hospital of Rethymno, 74132 Rethymno, Greece
Anthoula Chalkiadaki
Infection Control Committee, Organic Unit of Agios Nikolaos, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72100 Agios Nikolaos, Greece
Styliani Papathanasaki
Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
Chrisanthi Markopoulou
Infection Control Committee, Decentralized Organic Unit of Ierapetra, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72200 Ierapetra, Greece
Evagelia Magouli
Infection Control Committee, General Hospital-Health Care Center of Neapoli “Dialinakeio”, 72400 Neapoli, Greece
Maria Moustaki
Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
Vasileia-Athina Kataxaki
Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
Panagiotis Skevakis
Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece
Nikolaos Spernovasilis
School of Medicine, University of Crete, 71500 Heraklion, Greece
Georgios Chamilos
Department of Clinical Microbiology, University Hospital of Heraklion, 71500 Heraklion, Greece
Diamantis P. Kofteridis
Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece
Background: Both healthcare-associated infections (HAIs) and antimicrobial resistance are associated with an increased length of stay and hospital costs, while they have also been linked to high morbidity and mortality rates. In 2016 and 2017, the latest point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals highlighted an HAI prevalence of 6.5%, while Greece had a higher HAI prevalence of 10%. The aim of this PPS was to record the prevalence of HAIs and antimicrobial use in all eight public acute care hospitals in Crete, Greece during the COVID-19 pandemic in order to highlight the types of infections and antimicrobial practices that need to be prioritized for infection control initiatives. Methods: The PPS was conducted between 30 March and 15 April 2022, according to the ECDC standardized relevant protocol (version 5.3). Statistics were extracted using the ECDC Helics.Win.Net application (software version 4.1.0). Results: A total of 1188 patients were included. The overall point prevalence of patients with at least one HAI was 10.6%. The most frequent types of infections were pneumonia (34.3%), bloodstream infections (10.5%), systemic infections and urinary tract infections (10.5% and 9.1%, respectively). In 14 (12.4%) cases, the pathogen responsible for HAI was SARS-CoV-2 following onsite spread, accounting for almost 10% of all HAIs. Microorganisms were identified in 60.1% of HAIs. Antimicrobials were administered in 711 (59.8%) patients, with 1.59 antimicrobials used per patient. Conclusion: The prevalence of HAI and antimicrobial use among hospitalized patients in Crete, Greece was similar to the national HAI prevalence in 2016 despite the enormous pressure on public hospitals due to the COVID-19 pandemic. Nevertheless, both HAI prevalence and antimicrobial use remain high, underlining the need to implement adequate infection control and antimicrobial stewardship interventions.
