Multimodal surveillance of Care-related infections by Alert microorganisms in Ospedali Riuniti di Vittoria e Comiso ASP Ragusa

Abstract

Background: monitoring the incidence and surveillance of alert microorganism infections detected in inpatients of the Ospedali Riuniti di Vittoria and Comiso in 2023.

Objectives: early identification and implementation of shared pathways aimed at prevention and control of care-related infections. the spread of colonization and infections; promotion and implementation of effective risk assessment programs.

Methods: a multicenter study was conducted on 79 patients with infections with Alert microorganisms, in ordinary hospitalization, day service, and day hospital, of the "R. Guzzardi" hospitals of Vittoria and "R. Margherita" of Comiso. Sample stratification was performed according to gender, females 51.9% and males 48%, and the four age groups: 18-40 (4.8%), 41-60 (9.5%), 61-80 (45.2%), >80 (40.5%), x̄ 51.90. The calculated mortality rate was n.16 (20.25%). The types, number and frequency of use of invasive devices were described (n.68, 86%, including 64.5% urinary bladder catheter).

Results: the operating unit in which there is significant positivity to Alert infections is the UOC of Internal Medicine (40.5%), followed by RSA (16.46%) and ICU (8.86%), table1. The most representative Alert is Acinetobacter baumannii (24.05%), other microorganisms isolated are Klebsiella P. (22.78%), Escherichia c. (21.52%), and Staphylococcus A. (18.99%). In addition, a significant correlation between microorganisms and sample type is confirmed (p=0.019). Inpatient days are proportional to the care complexity index (p=0.0021). In addition, there is no correlation between inpatient days and microorganism type.

Conclusions: the reduction of inpatient time and the move toward territorial continuity of care will promote the community spread of selected antibiotic-resistant bacteria in the hospital. Surveillance measures include early identification of patients positive to Alerts, active follow-up of colonized patients, isolation of colonized/infected patients, and adoption of contact precautions in the management of such patients.