{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:17:43Z","timestamp":1794266263075,"version":"4.9.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Healthcare-Associated Infections (HAIs) are a global public health issue, representing a significant burden of disease that leads to prolonged hospital stays, inappropriate use of antimicrobial drugs, intricately linked to the development of resistant microorganisms, and higher costs for healthcare systems. The study aimed to measure the prevalence of HAIs, the use of antimicrobials, and assess healthcare- and patient-related risk factors, to help identify key intervention points for effectively reducing the burden of HAIs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 28 acute care hospitals in the Lombardy region, Northern Italy, participated in the third European Point Prevalence Survey (PPS-3) coordinated by ECDC for the surveillance of HAIs in acute care hospitals (Protocol 6.0).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>HAIs were detected in 1,259 (10.1%, 95% CI 9.6\u201310.7%) out of 12,412 enrolled patients. 1,385 HAIs were reported (1.1 HAIs per patient on average). The most common types of HAIs were bloodstream infections (262 cases, 18.9%), urinary tract infections (237, 17.1%), SARS-CoV-2 infections (236, 17.0%), pneumonia and lower respiratory tract infections (231, 16.7%), and surgical site infections (152, 11.0%). Excluding SARS-CoV-2 infections, the overall prevalence of HAIs was 8.4% (95% CI 7.9\u20138.9%). HAIs were significantly more frequent in patients hospitalized in smaller hospitals and in intensive care units (ICUs), among males, advanced age, severe clinical condition and in patients using invasive medical devices. Overall, 5,225 patients (42.1%, 95% CI 41.3\u201343.0%) received systemic antimicrobial therapy. According to the WHO\u2019s AWaRe classification, the Access group accounted for 32.7% of total antibiotic consumption, while Watch and Reserve classes accounted for 57.0% and 5.9% respectively. From a microbiological perspective, investigations were conducted on only 64% of the HAIs, showing, however, a significant pattern of antibiotic resistance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The PPS-3 in Lombardy, involving data collection on HAIs and antimicrobial use in acute care hospitals, highlights the crucial need for a structured framework serving both as a valuable benchmark for individual hospitals and as a foundation to effectively channel interventions to the most critical areas, prioritizing future regional health policies to reduce the burden of HAIs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-024-09487-7","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T07:02:20Z","timestamp":1719298940000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Healthcare-associated infections and antimicrobial use in acute care hospitals: a point prevalence survey in Lombardy, Italy, in 2022"],"prefix":"10.1186","volume":"24","author":[{"given":"Antonio","family":"Antonelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elena","family":"Ales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Chiecca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeno","family":"Dalla Valle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"De Ponti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Cereda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Crottogini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Renzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Signorelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Moro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"9487_CR1","doi-asserted-by":"publisher","unstructured":"Cassini A, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019;19(1). https:\/\/doi.org\/10.1016\/S1473-3099(18)30605-4","DOI":"10.1016\/S1473-3099(18)30605-4"},{"key":"9487_CR2","doi-asserted-by":"publisher","unstructured":"Stewart S, et al. Impact of healthcare-associated infection on length of stay. J Hosp Infect. 2021;114. https:\/\/doi.org\/10.1016\/j.jhin.2021.02.026","DOI":"10.1016\/j.jhin.2021.02.026"},{"key":"9487_CR3","doi-asserted-by":"publisher","unstructured":"Manoukian S, et al. Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. J Hosp Infect. 2021;114. https:\/\/doi.org\/10.1016\/j.jhin.2020.12.027","DOI":"10.1016\/j.jhin.2020.12.027"},{"key":"9487_CR4","unstructured":"Eyal Z et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med, 02120, 2013."},{"key":"9487_CR5","doi-asserted-by":"publisher","unstructured":"Roberts RR, et al. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods. Med Care. 2010;48(11). https:\/\/doi.org\/10.1097\/MLR.0b013e3181ef60a2","DOI":"10.1097\/MLR.0b013e3181ef60a2"},{"key":"9487_CR6","doi-asserted-by":"publisher","unstructured":"Murray CJ, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325). https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"9487_CR7","unstructured":"United Nations Environment Programme. Bracing for Superbugs: strengthening environmental action in the One Health response to antimicrobial resistance. Geneva, 2023."},{"key":"9487_CR8","doi-asserted-by":"publisher","unstructured":"Trivedi KK, et al. Implementing strategies to prevent infections in acute-care settings. Infect Control Hosp Epidemiol. 2023;44(8). https:\/\/doi.org\/10.1017\/ice.2023.103","DOI":"10.1017\/ice.2023.103"},{"key":"9487_CR9","unstructured":"Regional Committee for Europe. Sixty-first Regional Committee for Europe: Baku, 12\u201315 September 2011: European strategic action plan on antibiotic resistance, 2011."},{"key":"9487_CR10","doi-asserted-by":"publisher","unstructured":"Suetens C, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. 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Infect Control Hosp Epidemiol. 2001;22(1):31\u20134. https:\/\/doi.org\/10.1086\/501821."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09487-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09487-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09487-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T07:03:17Z","timestamp":1719298997000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09487-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9487"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09487-7","relation":{"references":[{"id-type":"uri","id":"","asserted-by":"subject"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]},"assertion":[{"value":"5 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This surveillance study received ethical approval from the University of Turin\u2019s Ethics Committee, Protocol no. 0421518 dated 29\/07\/2022. The approval of the Ethics Committee of each region or participating institution is not required for participation, as this study is part of a national surveillance program of a notifiable disease. The surveillance does not require obtaining informed consent from the enrolled patients. The study strictly adhered to ethical standards, ensuring the rights and well-being of all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"632"}}