Abstract:
Background: There are no contemporary data on healthcare-associated infections (HAIs) in New Zealand.
Aims: To determine the epidemiology of HAIs, prevalence of medical devices, and the microbiology of HAIs in adults in New Zealand public hospitals.
Methods: Point prevalence survey. Surveyors reviewed those ≥18 years applying the European Centres for Disease Control HAI definitions. Device use and microbiology of HAIs were recorded.
Findings: 5,468 patients were surveyed; 361 patients (6.6%) had 423 HAIs (7.7 HAIs per 100 patients). The commonest HAIs were: surgical site infection, 104 (25%); urinary tract infection, 80 (19%); pneumonia, 75 (18%); and bloodstream infection, 55 (13%). 3,585 patients (66%) had at least one device with 2,922 (53%) having a peripheral intravenous catheter. 69 (16%) HAIs were device-associated. After multivariable analysis, independent risk factors for HAIs included the presence of a peripheral (OR 2.0) or central intravenous catheter (OR 5.7), and clinical service, with surgical (OR 1.8), intensive care (OR 2.6) and rehabilitation/older persons health patients (OR 2.4) having higher rates of HAI than medical patients, P≤0.01 all groups. 301 organisms were identified. Clostridioides difficile infection was uncommon, 1.7% of all HAIs. 42 isolates (14%) were drug-resistant, most (33, 79%) being Enterobacterales isolates.
Conclusion: We have established the common HAIs and their risk factors in New Zealand. The high prevalence of device use underscores the need to ensure proven multimodal prevention interventions are in place. However, as less than half of HAIs are device- or surgery-associated other intervention strategies will be required to reduce their burden.
Reference:Grae N, Singh A, Jowitt D, Flynn A, Mountier E, Clendon G, Barratt R, Gibson B, Williams C, Roberts SA, Morris AJ. The prevalence of healthcare-associated infections in New Zealand Public Hospitals 2021. J Hosp Infect. 2022 Oct 18:S0195-6701(22)00332-2. doi: 10.1016/j.jhin.2022.10.002. Epub ahead of print. PMID: 36270518.