Prevalence of healthcare-associated infections and antibiotic use in Sicilian hospitals in 2022

INTRODUCTION: Point prevalence surveys (PPSs) of healthcare-associated infections (HAIs) and antibiotic use are crucial to monitor trends over years at regional level, especially in countries with decentralized healthcare systems. Here, we reported the results of the fourth PPS conducted in Sicilian acute care hospitals (Italy) in 2022. METHODS: The PPS was conducted according to the 6.1 version of the European Centre for Disease Prevention and Control protocol. Each ward carried out a single-day surveillance, including all patients admitted to the ward before or at 8 a.m. and not discharged at the time of the survey. The definition of an active HAI relied on the presence of signs and symptoms, the day of onset of symptoms in relation to hospital admission, and the possible presence of an invasive device before infection. RESULTS: We used data from 4496 patients from 52 acute care hospitals in Sicily (Italy), with a mean age of 60.7 years (50.9% females). Patients exposed to medical devices were 13.1% for central venous catheter, 37.6% for indwelling urinary catheter, and 4.0% for mechanically assisted ventilation. Antibiotic treatment was given to 48.6% of patients. Overall, our survey found 8.3% patients with at least one active HAI on the survey day. Of a total of 369 HAIs for which information was available, the most commonly reported types were pneumonia (22.2%), urinary tract infections (20.1%), and surgical site infections (10.3%). CONCLUSIONS: Approximately one in 12 patients has a HAI on a given day in Sicilian hospitals. This estimate is higher than that obtained through the previous Sicilian PPS conducted in 2018 (8.3% vs. 5.1%). By contrast, the proportion of patients who received at least one antimicrobial agent was lower than in 2018 (48.6% vs. 53.7%). Nevertheless, the high prevalence of HAIs observed underlines the need for maximising infection, prevention and control strategies and antibiotic stewardship programs against HAIs and antimicrobial resistance. KEY MESSAGES: • The prevalence of HAIs in Sicilian hospitals is higher than previous years. • There is the need for actions against HAIs and antimicrobial use at regional, national, and global levels.