The prevalence of and risk factors for healthcare-associated infections in Slovenia: results of the second national survey
, , , , , and | Jul 28, 2016
About this article
Article Category: Research article
Published Online: Jul 28, 2016
Page range: 239 - 247
Received: Apr 01, 2016
Accepted: May 10, 2016
DOI: https://doi.org/10.1515/sjph-2016-0033
Keywords
© National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
The number (N) and prevalence of different types of healthcare-associated infections (HAIs) overall and according to ward specialties, Slovenian national healthcare-associated infections prevalence survey, 2011.
| Intensive care | General medicine | Surgery | Gynaecology & obstetrics | Paediatrics | Other/mixed | All | |
|---|---|---|---|---|---|---|---|
| N (prevalence) | N (prevalence) | N (prevalence) | N (prevalence) | N (prevalence) | N (prevalence) | N (prevalence) | |
| Urinary tract infections | 8 ( 3.9%) | 35 (1.7%) | 28 (1.3%) | 4 (0.7%) | 1 (0.3%) | 1 (0.3%) | 77 (1.4%) |
| Pneumoniae | 30 (14.5%) | 25 (1.2%) | 19 (0.9%) | 0 (0.0%) | 1 (0.3%) | 0 (0.0%) | 75 (1.3%) |
| Surgical site infections | 9 ( 4.3%) | 5 (0.2%) | 48 (2.3%) | 3 (0.5%) | 0 (0.0%) | 1 (0.3%) | 66 (1.2%) |
| Systemic infections | 12 ( 5.8%) | 22 (1.0%) | 13 (0.6%) | 1 (0.2%) | 6 (1.6%) | 1 (0.3%) | 55 (1.0%) |
| Bloodstream infections (BSIs) | 12 ( 5.8%) | 14 (0.7%) | 7 (0.3%) | 1 (0.2%) | 0 (0.0%) | 0 (0.0%) | 34 (0.6%) |
| Gastro-intestinal system infections | 6 ( 2.9%) | 11 (0.5%) | 5 (0.2%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 22 (0.4%) |
| Other lower respiratory tract infections | 10 ( 4.8%) | 5 (0.2%) | 6 (0.3%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 21 (0.4%) |
| Bone and joint infections | 0 (0.0%) | 1 (0.0%) | 14 (0.7%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 15 (0.3%) |
| Skin and soft tissue infections | 1 (0.5%) | 6 (0.3%) | 6 (0.3%) | 0 (0.0%) | 0 (0.0%) | 1 (0.3%) | 14 (0.2%) |
| Eye, Ear, Nose or Mouth infections | 0 ( 0.0%) | 6 (0.3%) | 0 (0.0%) | 0 (0.0%) | 1 (0.3%) | 0 (0.0%) | 7 (0.1%) |
| Cardiovascular system infections | 0 ( 0.0%) | 3 (0.1%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 3 (0.1%) |
| Catheter-related infections w/o BSIs | 0 ( 0.0%) | 2 (0.1%) | 1 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 3 (0.1%) |
| Reproductive tract infections | 0 ( 0.0%) | 0 (0.0%) | 0 (0.0%) | 3 (0.5%) | 0 (0.0%) | 0 (0.0%) | 3 (0.1%) |
| Patients with at least one HAI Patients can have several HAIs, thus the numbers in columns do not necessarily add up to the number of patients with at least one HAI. | 74 (35.7%) | 125 (5.9%) | 134 (6.4%) | 12 (2.2%) | 9 (2.4%) | 4 (1.3%) | 358 (6.4 %) |
The prevalence of healthcare-associated infections (HAIs) acquired during current hospitalization according to patients’ characteristics, ward specialties, and exposure to extrinsic risks and results of univariate analysis of association, Slovenian national healthcare-associated infections prevalence survey, 2011.
| The prevalence of patients with HAIs | The number of patients (base) | Odds ratio | P-value (95% CI) | |
|---|---|---|---|---|
| Sex | ||||
| Male | 6.5% | 2692 | 1 | P<0.001 |
| Female | 4.2% | 2936 | 0.6 | (0.5-0.8) |
| Age | ||||
| <50 years | 2.2% | 1919 | 1 | P<0.001 |
| 50-79 years | 6.8% | 2866 | 3.2 | (2.3-4.5) |
| ≥80 years | 7.5% | 843 | 3.6 | (2.4-5.4) |
| McCabe index | ||||
| Non-fatal disease | 3.5% | 4394 | 1 | P<0.001 |
| Ultimately fatal disease | 10.9% | 921 | 3.4 | (2.6-4.4) |
| Rapidly fatal disease | 15.0% | 287 | 4.9 | (3.4-7.0) |
| Specialities | ||||
| General medicine | 5.1% | 2105 | 1 | P<0.001 |
| Surgery | 4.9% | 2082 | 1.0 | (0.7-1.3) |
| Gynaecology & obstetrics | 2.0% | 557 | 0.4 | (0.2-0.7) |
| Paediatrics | 1.6% | 375 | 0.3 | (0.1-0.7) |
| Intensive care | 33.8% | 207 | 9.5 | (6.7-13.5) |
| Other | 1.0% | 302 | 0.2 | (0.1-0.6) |
| Surgery - current hospitalization | ||||
| No | 3.4% | 3908 | 1 | P<0.001 |
| Yes | 9.7% | 1719 | 3.1 | (2.4-3.9) |
| Implant during the last 12 months | ||||
| No | 4.7% | 4893 | 1 | P<0.001 |
| Yes | 9.2% | 535 | 2.1 | (1.5-2.8) |
| Intubation | ||||
| No | 4.4% | 5457 | 1 | P<0.001 |
| Yes | 35.9% | 170 | 12.3 | (8.7-17.2) |
| Central vascular catheter | ||||
| No | 3.5% | 5216 | 1 | P<0.001 |
| Yes | 28.5% | 410 | 11.0. | (8.5-14.3) |
| Peripheral vascular catheter | ||||
| No | 3.4% | 2992 | 1 | P<0.001 |
| Yes | 7.5% | 2635 | 2.3 | (1.8-2.9) |
| Urinary catheter | ||||
| No | 3.0% | 4715 | 1 | P<0.001 |
| Yes | 17.1% | 911 | 6.6 | (5.2-8.4) |
| Length of hospital stay The length of hospital stay was computed until the day of the survey for patients without HAIs acquired during the current hospitalization and for those with HAIs acquired during the current hospitalization until the day of occurrence of HAIs (first HAI, if several). | ||||
| s 3 days | 1.4% | 1899 | 1 | P<0.001 |
| 4-7 days | 4.8% | 1630 | 3.5 | (2.2-5.4) |
| 8-14 days | 7.2% | 1112 | 5.4 | (3.5-8.4) |
| ≥ 15 days | 11.6% | 987 | 9.1 | (5.9-13.9) |
A distribution of surveyed patients between acute-care hospitals and different ward specialties, Slovenian national healthcare-associated infections prevalence survey, 2011.
| Acute-care hospitals | The number of patients | ||||||
|---|---|---|---|---|---|---|---|
| General medicine | Surgery | Gynaecology & obstetrics | Paediatrics | Intensive care | Other/mixed | All | |
| University Medical Centre Ljubljana | 629 | 707 | 175 | 143 | 88 | 0 | 1742 |
| University Medical Centre Maribor | 295 | 388 | 45 | 38 | 24 | 201 | 991 |
| General Hospital Celje | 146 | 177 | 89 | 28 | 13 | 11 | 464 |
| General Hospital Novo mesto | 124 | 143 | 43 | 18 | 14 | 0 | 342 |
| General Hospital Nova Gorica | 92 | 103 | 38 | 16 | 9 | 22 | 280 |
| General Hospital Murska Sobota | 126 | 84 | 37 | 19 | 8 | 0 | 274 |
| General Hospital Izola | 82 | 57 | 28 | 11 | 8 | 0 | 186 |
| General Hospital Slovenj Gradec | 68 | 69 | 0 | 22 | 3 | 21 | 183 |
| Oncology Institute Ljubljana | 139 | 35 | 0 | 0 | 8 | 0 | 182 |
| General Hospital Jesenice | 53 | 62 | 0 | 26 | 4 | 19 | 164 |
| Orthopaedic Hospital Valdoltra | 0 | 149 | 0 | 0 | 0 | 0 | 149 |
| Clinic Golnik | 130 | 0 | 0 | 0 | 6 | 0 | 136 |
| General Hospital Ptuj | 47 | 41 | 9 | 18 | 7 | 0 | 122 |
| General Hospital Trbovlje | 33 | 25 | 28 | 6 | 3 | 0 | 95 |
| General Hospital Brežice | 36 | 23 | 0 | 2 | 4 | 22 | 87 |
| Hospital Topolšica | 70 | 0 | 0 | 0 | 4 | 0 | 74 |
| Gynaecology & Obstetrics Hospital Postojna | 0 | 0 | 35 | 16 | 0 | 0 | 51 |
| Gynaecology & Obstetrics Hospital Kranj | 0 | 0 | 30 | 12 | 0 | 0 | 42 |
| Diagnostic Centre Bled | 35 | 0 | 0 | 0 | 0 | 0 | 35 |
| Surgical Centre Rožna dolina | 0 | 18 | 0 | 0 | 0 | 0 | 18 |
| Medicor | 0 | 1 | 0 | 0 | 4 | 6 | 11 |
| All | 2105 | 2082 | 557 | 375 | 207 | 302 | 5628 |
| Proportion (%) | 37.4% | 37.0% | 9.9% | 6.7% | 3.7% | 5.4% | 100% |
The prevalence of exposures to indwelling devices on the day of the survey, Slovenian national healthcare-associated infection prevalence survey, 2011.
| Intensive care | General medicine | Surgery | Gynaecology & obstetrics | Paediatrics | Other/mixed | All | |
|---|---|---|---|---|---|---|---|
| Peripheral vascular catheter | 77.8% | 50.3% | 50.7% | 21.2% | 50.1% | 18.2% | 46.8% |
| Central vascular catheter | 72.5% | 5.7% | 5.7% | 0.5% | 5.1% | 0.3% | 7.3% |
| Urinary catheter | 82.1% | 15.1% | 17.8% | 7.4% | 0.0% | 4.3% | 16.2% |
| Intubation | 53.1% | 0.6% | 2.0% | 0.9% | 0.0% | 0.3% | 3.0% |
| Number of patients (100%) | 207 | 2105 | 2082 | 557 | 375 | 302 | 5628 |
Risk factors for healthcare-associated infections (HAIs) acquired during current hospitalization, results of multivariate and relevant univariate analysis of association, Slovenian national healthcare-associated infections prevalence survey, 2011.
| Unadjusted | Adjusted Adjusted for all other risk factors shown in table. The length of hospital stay was computed until the day of the survey for patients without HAIs acquired during current hospitalization and for those with HAIs acquired during current hospitalization until the day of occurrence of HAIs (first HAI if several). | |||||
|---|---|---|---|---|---|---|
| The prevalence of patients with HAIs | The number of patients (bases) | Odds ratio | Odds ratio | |||
| Age | ||||||
| <50 | 2.2% | 1913 | 1 | P<0.001 | 1 | P=0.001 |
| 50-79 | 6.7% | 2849 | 3.2 | (2.3-4.5) | 1.8 | (1.2-2.6) |
| ≥80 | 7.5% | 836 | 3.6 | (2.4-5.4) | 2.2 | (1.4-3.4) |
| McCabe index | ||||||
| Nonfatal disease | 3.5% | 4392 | 1 | P<0.001 | 1 | P=0.001 |
| Ultimately fatal disease | 10.9% | 919 | 3.4 | (2.6-4.4) | 1.4 | (1.0-1.9) |
| Rapidly fatal disease | 15.0 | 287 | 4.8 | (3.4-7.0) | 2.1 | (1.4-3.3) |
| Surgery - current hospitalization | ||||||
| No | 3.4% | 3886 | 1 | P<0.001 | 1 | P<0.001 |
| Yes | 9.6% | 1712 | 3.0 | (2.4-3.8) | 1.9 | (1.5-2.5) |
| Intubation | ||||||
| No | 4.4% | 5428 | 1 | P<0.001 | 1 | P<0.001 |
| Yes | 35.9% | 170 | 12.3 | (8.8-17.3) | 2.3 | (1.4-3.5) |
| Central vascular catheter | ||||||
| No | 3.5% | 5191 | 1 | P<0.001 | 1 | P<0.001 |
| Yes | 28.5% | 407 | 11.0 | (8.5-14.3) | 4.0 | (2.9-5.7) |
| Peripheral vascular catheter | ||||||
| No | 3.4% | 2981 | 1 | P<0.001 | 1 | P<0.001 |
| Yes | 7.5% | 2617 | 2.3 | (1.7-2.9) | 2.0 | (1.5-2.6) |
| Urinary catheter | ||||||
| No | 3.0% | 4690 | 1 | P<0.001 | 1 | P<0.001 |
| Yes | 17.1% | 908 | 6.6 | (5.2-8.4) | 1.8 | (1.3-2.4) |
| Hospital stayb | ||||||
| s 3 days | 0.3% | 1862 | 1 | P<0.001 | 1 | P<0.001 |
| 4-7 days | 2.2% | 1873 | 3.4 | (2.2-5.3) | 2.8 | (1.7-4.4) |
| 8-14 days | 7.5% | 909 | 5.4 | (3.4-8.3) | 3.8 | (2.4-6.0) |
| ≥ 15 days | 19.1% | 954 | 9.0 | (5.9-13.8) | 5.3 | (3.3-8.3) |