AMSTERDAM (360Dx) – Hospital-acquired infections are a growing problem in European health facilities, and more microbiological testing is needed for effective control and treatment, according to the European Centre for Disease Control and Prevention.
At the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) conference held here over the weekend, the ECDC said the lack of available microbiological testing could be hampering treatment, infection surveillance, prevention, and control of HAIs.
The findings stem from an assessment of HAIs that the ECDC conducted in Europe between 2016 and 2017. The assessment leverages data from two surveys about HAIs and antimicrobial use in acute-care hospitals and long-term care facilities in European Union and European Economic Area countries.
Trained staff used standardized questionnaires to collect data from acute-care hospitals and long-term care facilities, including general nursing homes and residential homes participating on a voluntary basis.
The analysis included 310,755 patients from 1,209 acute-care hospitals in 28 EU/EEA countries, and 117,138 residents from 1,798 long-term care facilities in 24 EU/EEA countries.
Countries with lower testing rates, such as Lithuania, Hungary, and Romania, detected fewer HAIs than countries with higher testing rates, such as Finland, Belgium, and the UK, and the different rates at which blood samples are tested influence reported rates for national healthcare-associated infections (HAIs), the agency said.
The ECDC noted that only 19 percent of HAIs had a microbiological test result available to guide control and treatment in long-term care facilities, while 53 percent of HAIs had a microbiological test result available to guide control and treatment in acute-care hospitals.
Respiratory tract infections — particularly pneumonia — were the most common conditions, accounting for a quarter of all HAIs in hospitals and a third in long-term care facilities. Urinary tract infections accounted for almost a fifth of all HAIs in hospitals and a third in long-term care facilities.
ECDC noted that the burden of HAIs — such as pneumonia, urinary tract infections, and Clostridium difficile infections — in European acute-care hospitals exceeded the combined burden of all other infectious diseases under surveillance by ECDC, including influenza, HIV/AIDS, and tuberculosis.
According to ECDC estimates, 9 million HAI cases occur across Europe each year. About one in 15 patients in acute-care hospitals and one in 24 residents in long-term care facilities have at least one HAI on any given day.
In 2016 and 2017, the prevalence of healthcare-associated infection in acute care hospitals ranged from 3 percent to 10 percent of patients. In long-term care facilities, the prevalence ranged from 1 percent to more than 8 percent of residents.
Pete Kinross, a researcher into surveillance of healthcare-associated infection at the ECDC, said in a statement that "the variability of microbiological testing suggests poor availability of information for effective treatment, as well as [for] alertness to potential outbreaks."
Researchers, meanwhile, are investigating algorithm-driven screening methods and advanced testing approaches such as metagenomics sequencing in the quest to stem HAIs.