{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:42:05Z","timestamp":1790401325190,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction. Healthcare-associated infections (HAIs) are a serious problem of modern medicine. Patients hospitalized in intensive care units (ICUs) develop HAI significantly more often than patients in other hospital units. Materials and Methods. Analysis involved HAIs from three ICUs in southern Poland. The study was conducted in 2016\u20132019 on the basis of methodology recommended by the Healthcare-Associated Infections Surveillance Network (HAI-Net) and European Centre for Disease Prevention and Control (ECDC). The objective was to analyse HAIs, their clinical forms, and microbiological agents. Results. The study included 3028 patients hospitalized for 26,558 person-days (pds) in ICU. A total of 540 HAIs were detected; incidence per 100 hospitalizations was 17.8%, incidence density per 1000 pds was 20.3. The mortality of patients with HAI was 16%, and in Clostridioidesdifficile infection (CDI), the mortality was 28%. The most common clinical form of HAI was bloodstream infection (BSI): 209 cases (incidence rate 6.9%), followed by pneumonia (PN): 131 (incidence rate 4.3%), and urinary tract infection (UTI): 110 cases (incidence rate 3.6%). The most frequently isolated bacteria were Klebsiella pneumoniae 16.4%, Acinetobacter baumannii 14.4%, Staphylococcus aureus 11.8%, and Escherichia coli 11.4%. Conclusions. A two-fold higher incidence rate of BSI was detected compared to the average incidence in European countries. BSI of unknown source (BSI-UNK) was predominant. K. pneumoniae and A. baumannii bacteria were the most often isolated microorganisms causing HAI. Infection control based on incidence rate for each type of infection is necessary in ICU to assess the epidemiological situation.<\/jats:p>","DOI":"10.3390\/ijerph18052238","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T20:53:21Z","timestamp":1614200001000},"page":"2238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Incidence of Healthcare-Associated Infections, Their Clinical Forms, and Microbiological Agents in Intensive Care Units in Southern Poland in a Multicentre Study from 2016 to 2019"],"prefix":"10.3390","volume":"18","author":[{"given":"El\u017cbieta","family":"Rafa","sequence":"first","affiliation":[{"name":"State Higher Vocational School in Nowy S\u0105cz, 33-300 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Z.","family":"Wa\u0142aszek","sequence":"additional","affiliation":[{"name":"State Higher Vocational School in Tarn\u00f3w, St. Luke Provincial Hospital in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142 J.","family":"Wa\u0142aszek","sequence":"additional","affiliation":[{"name":"Polish Society of Hospital Infections, 31-121 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9452-8361","authenticated-orcid":false,"given":"Adam","family":"Doma\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Distributed Systems and IT Equipment, Electronics and Computer Science, Faculty of Automatic Control, The Silesian Technical University, 44-100 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"R\u00f3\u017ca\u0144ska","sequence":"additional","affiliation":[{"name":"Chair of Microbiology, Jagiellonian University Medical College, Czysta str. 18, 31-121 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"PH17","DOI":"10.12659\/MSM.881434","article-title":"Evaluation of nosocomial infections and risk factors in critically ill patients","volume":"17","author":"Ozer","year":"2011","journal-title":"Med. Sci. Monit."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1055\/s-2006-945534","article-title":"Infection control and the prevention of nosocomial infections in the intensive care unit","volume":"27","author":"Bearman","year":"2006","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_3","first-page":"165","article-title":"Information on nosocomial infections in the mainstream media: An opinion document","volume":"32","author":"Bouza","year":"2019","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Barchitta, M., Quattrocchi, A., Maugeri, A., La Rosa, M.C., La Mastra, C., Sessa, L., Cananzi, P., Murolo, G., Oteri, A., and Basile, G. (2019). Antibiotic Consumption and Resistance during a 3-Year Period in Sicily, Southern Italy. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16132253"},{"key":"ref_5","unstructured":"Antimicrobial Resistance in the EU\/EEA (EARS-Net) (2021, February 13). Annual Epidemicological Report for 2019. European Centre for Disease Control and Prevention. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/surveillance-antimicrobial-resistance-Europe-2019.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5670238","DOI":"10.1155\/2018\/5670238","article-title":"Surveillance of Antibiotic Prescribing in Intensive Care Units in Poland","volume":"2018","author":"Trejnowska","year":"2018","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.jiph.2018.02.003","article-title":"Antibiotic consumption versus the prevalence of multidrug-resistant Acinetobacter baumannii and Clostridium difficile infections at an ICU from 2014\u20132015","volume":"11","author":"Krawczyk","year":"2018","journal-title":"J. Infect. Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1128\/CMR.17.4.863-893.2004","article-title":"Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs","volume":"17","author":"Kampf","year":"2004","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_9","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Surveillance of Healthcare-Associated Infections in Europe, 2007, Available online: http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/120215_SUR_HAI_2007.pdf."},{"key":"ref_10","first-page":"20","article-title":"Monitorowanie zaka\u017ce\u0144 szpitalnych w oddziale intensywnej terapii medycznej","volume":"56","year":"2010","journal-title":"Ann. Acad. Med. Stetin."},{"key":"ref_11","first-page":"e5","article-title":"Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International Nosocomial Infection Control Consortium\u2019s (INICC) findings","volume":"27","author":"Rosenthal","year":"2012","journal-title":"J. Crit. Care"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ko\u0142pa, M., Wa\u0142aszek, M., Gniadek, A., Wolak, Z., and Dobro\u015b, W. (2018). Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15010112"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Duszynska, W., Rosenthal, V.D., Szczesny, A., Zajaczkowska, K., Fulek, M., and Tomaszewski, J. (2020). Device associated -health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015-2017). BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05482-w"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"190","DOI":"10.5507\/bp.2018.006","article-title":"Zesp\u00f3\u0142 Polskiego Towarzystwa Zaka\u017ce\u0144 Szpitalnych. Epidemiology of Healthcare-Associated Infections in Polish Intensive Care. A Multicenter Study Based on Active Surveillance","volume":"162","author":"Walaszek","year":"2018","journal-title":"Biomed. Pap. Med. Fac. Univ. Palacky O\u0142omuniec Czech Repub."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5603\/AIT.a2016.0039","article-title":"Selected aspects of epidemiological surveillance in the intensive care unit of the Centre of Pulmonology and Thoracic Surgery in Bystra","volume":"48","author":"Dubiel","year":"2016","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_16","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Healthcare-associated infections acquired in intensive care units, Annual Epidemiological Report for 2017, Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/AER_for_2017-HAI.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1086\/657912","article-title":"Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs","volume":"32","author":"Umscheid","year":"2011","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_18","first-page":"399","article-title":"Multimodal surveillance of healthcare associated infections in an intensive care unit of a large teaching hospital","volume":"31","author":"Migliara","year":"2019","journal-title":"Annali di Igiene"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"c309","DOI":"10.1136\/bmj.c309","article-title":"Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: Observational study","volume":"340","author":"Pronovost","year":"2010","journal-title":"BMJ"},{"key":"ref_20","unstructured":"(2002). Commission Implementing Decision of 8 August 2012 Amending Decision 2002\/253\/EC Laying Down Case Definitions for Reporting Communicable Diseases to the Community Network under Decision No 2119\/98\/EC of the European Parliament and of the Council. Off. J. Eur. Union., Available online: https:\/\/eur-lex.europa.eu\/legalcontent\/EN\/TXT\/HTML\/?uri=CELEX:32012D0506."},{"key":"ref_21","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Point Prevalence Survey of Healthcare\u2014Associated Infections and Antimicrobial Use in European Acute Care Hospitals\u2014Protocol Version 4.3, Available online: http:\/\/ecdc.europa.eu\/en\/publications\/publications\/0512-ted-pps-hai-antimicrobial-use-protocol.pdf."},{"key":"ref_22","unstructured":"Dubiel, G., Koz\u0142owski, B., Deptu\u0142a, A., and Hryniewicz, W. (2021, January 14). Raport NPOA z Programu Czynnego Monitorowania Zaka\u017ce\u0144 w Oddzia\u0142ach Anestezjologii i Intensywnej Terapii w 2018 Roku w Polsce. Available online: http:\/\/antybiotyki.edu.pl\/wp-content\/uploads\/2020\/07\/Raport-ICU-2018.pdf."},{"key":"ref_23","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in European Acute Care Hospitals 2011\u20132012, Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-0."},{"key":"ref_24","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Annual Epidemiological Report 2016, Available online: https:\/\/ecdc.europa.eu\/en\/publications-data\/infections-acquired-intensive-care-units-annual-report-2016."},{"key":"ref_25","first-page":"115","article-title":"Polish Society of Hospital Infections Team. Alarming results of nosocomial bloodstream infections surveillance in polish intensive care units","volume":"72","author":"Bulanda","year":"2018","journal-title":"Przegl Epidemiol."},{"key":"ref_26","first-page":"225","article-title":"Hospital Acquired Pneumonia at the Intensive Care Units. The Active Nosocomial Infections Surveillance Programme of Polish Society of Hospital Infections","volume":"60","author":"Bulanda","year":"2006","journal-title":"Przegl Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wa\u0142aszek, M., R\u00f3\u017ca\u0144ska, A., Wa\u0142aszek, M.Z., W\u00f3jkowska-Mach, J., and The Polish Society of Hospital Infections Team (2018). Epidemiology of Ventilator-Associated Pneumonia, microbiological diagnostics and the length of antimicrobial treatment in the Polish Intensive Care Units in the years 2013\u20132015. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3212-8"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1089\/mdr.2015.0224","article-title":"Molecular Epidemiology and Drug Resistance of Acinetobacter Baumannii Isolated from Hospitals in Southern Poland: ICU as a Risk Factor for XDR Strains","volume":"22","author":"Chmielarczyk","year":"2016","journal-title":"Microb. Drug Resist."},{"key":"ref_29","unstructured":"European Centre for Disease Prevention and Control (2018). Surveillance of Antimicrobial Resistance in Europe\u2014Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) 2017."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5603\/AIT.2016.0001","article-title":"Urinary Tract Infections in Intensive Care Unit Patients\u2014A Single-Centre, 3-year Observational Study According to the INICC Project","volume":"48","author":"Rosenthal","year":"2016","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30025","DOI":"10.2807\/1560-7917.ES.2015.20.38.30025","article-title":"Hospital-based Clostridium Difficile Infection Surveillance Reveals High Proportions of PCR Ribotypes 027 and 176 in Different Areas of Poland, 2011 to 2013","volume":"20","author":"Pituch","year":"2015","journal-title":"Eurosurveillance"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"191","DOI":"10.14745\/ccdr.v45i78a04","article-title":"Epidemiology of Clostridioides difficile infection in Canada: A six-year review to support vaccine decision-making","volume":"45","author":"Xia","year":"2019","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_33","unstructured":"European Centre for Disease Prevention and Control (2021, January 14). Healthcare-associated infections: Clostridium difficile infections, Annual Epidemiological Report for 2016, Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/AER_for_2016-C-difficile_0.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jinf.2008.10.002","article-title":"The Acquisition and Outcome of ICU-acquired Clostridium Difficile Infection in a Single Centre in the UK","volume":"57","author":"Ang","year":"2008","journal-title":"J. Infect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jhin.2015.03.005","article-title":"Risk factors for healthcare-associated infection in light of two years of experience with the ECDC point prevalence survey of healthcare-associated infection and antimicrobial use in Poland","volume":"90","author":"Trejnowska","year":"2015","journal-title":"J. Hosp. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Barchitta, M., Maugeri, A., La Rosa, M.C., La Mastra, C., Murolo, G., and Agodi, A. (2021). Three-Year Trends of Healthcare-Associated Infections and Antibiotic Use in Acute Care Hospitals: Findings from 2016\u20132018 Point Prevalence Surveys in Sicily, Italy. Antibiotics, 10.","DOI":"10.3390\/antibiotics10111360"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:27:54Z","timestamp":1760160474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,24]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["ijerph18052238"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18052238","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,24]]}}}