Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012

Euro Surveill. 2018 Aug;23(32):1700843. doi: 10.2807/1560-7917.ES.2018.23.32.1700843.

Abstract

An aim of the ECDC point prevalence survey (PPS) in European Union/European Economic Area acute care hospitals was to acquire standardised healthcare-associated infections (HAI) data. We analysed one of the most common HAIs in the ECDC PPS, healthcare-associated pneumonia (HAP). Standardised HAI case definitions were provided and countries were advised to recruit nationally representative subsets of hospitals. We calculated 95% confidence intervals (CIs) around prevalence estimates and adjusted for clustering at hospital level. Of 231,459 patients in the survey, 2,902 (1.3%; 95% CI: 1.2-1.3) fulfilled the case definition for a HAP. HAPs were most frequent in intensive care units (8.1%; 95% CI: 7.4-8.9) and among patients intubated on the day of the survey (15%; 95% CI: 14-17; n = 737 with HAP). The most frequently reported microorganism was Pseudomonas aeruginosa (17% of 1,403 isolates), followed by Staphylococcus aureus (12%) and Klebsiella spp. (12%). Antimicrobial resistance was common among isolated microorganisms. The most frequently prescribed antimicrobial group was penicillins, including combinations with beta-lactamase inhibitors. HAPs occur regularly among intubated and non-intubated patients, with marked differences between medical specialities. HAPs remain a priority for preventive interventions, including surveillance. Our data provide a reference for future prevalence of HAPs at various settings.

Keywords: Europe; antibiotic use; antimicrobial resistance; epidemiology; healthcare-associated infections; infection prevention and control; pneumonia; point prevalence survey; surveillance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Europe / epidemiology
  • European Union
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification*
  • Healthcare-Associated Pneumonia / drug therapy
  • Healthcare-Associated Pneumonia / epidemiology*
  • Healthcare-Associated Pneumonia / microbiology
  • Humans
  • Infant
  • Infant, Newborn
  • Inpatients
  • Intensive Care Units
  • Klebsiella / drug effects
  • Klebsiella / isolation & purification
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / isolation & purification
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents