{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:08:41Z","timestamp":1773983321334,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:00:00Z","timestamp":1733529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Healthcare-associated infections (HAIs) represent a major challenge in patient safety that affects services disproportionally. This paper aimed to assess how the HAI prevalence varies between hospital services and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey of HAI prevalence. The study variables included patient, structural, and process variables, tested as risk factors, with patients clustered in hospitals. Variables with a p-value \u2264 0.2 in univariate analyses were retested in a multivariable model. A total of 18,261 patients from 119 hospitals were included: 736 from 56 intensive care units (ICUs), 3160 from 72 surgical departments, and 8081 from 90 medical departments. The HAI prevalence was 7.9%, 5.9%, and 1.7%, respectively. In ICUs, only the number of devices was associated with the HAI prevalence. In surgical departments, age, comorbidities, being a specialized hospital, and a higher ratio of infection prevention and control (IPC) personnel were associated with higher SSI. The safety climate was associated with lower SSI. In medical departments, age and devices were positively associated, whereas a larger ratio of IPC nurses was negatively associated. These results may help implement targeted interventions to achieve optimal results in each department.<\/jats:p>","DOI":"10.3390\/microorganisms12122522","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T06:16:14Z","timestamp":1733724974000},"page":"2522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hospital Context Determinants of Variability in Healthcare-Associated Infection Prevalence: Multi-Level Analysis"],"prefix":"10.3390","volume":"12","author":[{"given":"Rui","family":"Malheiro","sequence":"first","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas, n\u00b0 135, 4050-600 Porto, Portugal"},{"name":"Departamento de Ci\u00eancias da Sa\u00fade P\u00fablica e Forenses, e Educa\u00e7\u00e3o M\u00e9dica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Unidade de Sa\u00fade P\u00fablica S\u00e3o Jo\u00e3o, Unidade Local de S\u00e3o Jo\u00e3o, 4200-510 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7928","authenticated-orcid":false,"given":"Andr\u00e9 Amaral","family":"Gomes","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Intensiva, Hospital CUF, 4100-180 Porto, Portugal"},{"name":"Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Grupo Infe\u00e7\u00e3o e Sepsis, 4150-375 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7481-6764","authenticated-orcid":false,"given":"Carlos","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade Coimbra, 3004-561 Coimbra, Portugal"}]},{"given":"Ana","family":"Fareleira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cirurgia Geral, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Ana","family":"Lebre","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Doen\u00e7as Infeciosas\/Unidade Local do Programa de Preven\u00e7\u00e3o e Controlo de Infe\u00e7\u00e3o e Resist\u00eancia aos Antimicrobianos, Instituto Portugu\u00eas de Oncologia do Porto Francisco Gentil, E. P. E., 4200-072 Porto, Portugal"},{"name":"Dire\u00e7\u00e3o-Geral de Sa\u00fade, 1000-123 Lisboa, Portugal"}]},{"given":"Dulce","family":"Pascoalinho","sequence":"additional","affiliation":[{"name":"Grupo Infe\u00e7\u00e3o e Sepsis, 4150-375 Porto, Portugal"},{"name":"Dire\u00e7\u00e3o-Geral de Sa\u00fade, 1000-123 Lisboa, Portugal"},{"name":"Servi\u00e7o de Medicina Intensiva, Unidade Local de Sa\u00fade Litoral Alentejano, 7540-230 Santiago do Cac\u00e9m, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-3777","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Gon\u00e7alves-Pereira","sequence":"additional","affiliation":[{"name":"Grupo Infe\u00e7\u00e3o e Sepsis, 4150-375 Porto, Portugal"},{"name":"Servi\u00e7o de Medicina Intensiva, Unidade Local de Sa\u00fade Estu\u00e1rio do Tejo, 2600-009 Vila Franca de Xira, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Medicina Intensiva, Faculdade de Medicina, Universidade de Lisboa, 1649-004 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-0220","authenticated-orcid":false,"given":"Jos\u00e9-Artur","family":"Paiva","sequence":"additional","affiliation":[{"name":"Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Grupo Infe\u00e7\u00e3o e Sepsis, 4150-375 Porto, Portugal"},{"name":"Servi\u00e7o de Medicina Intensiva, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Rita","family":"S\u00e1-Machado","sequence":"additional","affiliation":[{"name":"Dire\u00e7\u00e3o-Geral de Sa\u00fade, 1000-123 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,7]]},"reference":[{"key":"ref_1","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. 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