Healthcare-associated infections and antimicrobial use in a Greek tertiary hospital: two cross-sectional point-prevalence surveys in 2012 and 2022

Abstract

Abstract Objective: To describe and cautiously compare two cross-sectional snapshots of healthcare-associated infections (HAIs) and antimicrobial use (AU) at the same Greek tertiary hospital in 2012 and 2022. Design: Secondary analysis of two cross-sectional point-prevalence surveys using European Centre for Disease Prevention and Control protocol versions 4.3 and 6.1. Setting: A public tertiary-care university referral hospital in northwestern Greece. Patients: Eligible inpatients present in participating wards before 08:00; 276 patients were included in 2012 and 391 in 2022. Methods: Patient-level HAI prevalence was the primary comparison, and AU prevalence was secondary. Infection site, microbiological, susceptibility, antimicrobial indication, and prophylaxis findings were analyzed descriptively because only aggregate outputs were available. Results: HAI prevalence was 23/276 (8.3%) in 2012 and 48/391 (12.3%) in 2022 (prevalence ratio [PR], 1.47; 95% confidence interval [CI], 0.92–2.36; P = .126). AU prevalence was 147/276 (53.3%) and 206/391 (52.7%), respectively (PR, 0.99; 95% CI, 0.86–1.14; P = .937). Pneumonia was the most frequently recorded infection-site category in both surveys. Surgical prophylaxis exceeded 1 day in 51/58 (87.9%) courses in 2012 and 47/48 (97.9%) in 2022. Protocol-year carbapenem non-susceptibility markers were frequent among small numbers of tested isolates. Conclusions: Both snapshots showed substantial HAI and AU burdens. The observed HAI difference cannot be separated from changes in patient mix, season, the COVID-19 pandemic, surveillance practices, and protocol definitions. Prolonged surgical prophylaxis was highly prevalent at both survey dates and represents a clear stewardship target.