Prevalence of healthcare device-associated infection using point prevalence surveys of antimicrobial prescribing and existing electronic data

Abstract

This study extended a previously described method for the prevalence of healthcare-associated infection, based on point prevalence surveys of antimicrobial prescribing and electronic data, to estimate the prevalence of device-associated infections. In June 2009, the six-month point prevalence survey of antimicrobial prescribing was carried out in accordance with the European Surveillance of Antimicrobial Consumption Protocol. For patients receiving antimicrobials the presence of devices was recorded. A census on device use was carried out concurrently in the relevant hospitals. We selected patients receiving antimicrobials, started >48h after admission and who had a device, or who were without a device but were receiving antimicrobials for the treatment of bloodstream infection, urinary tract infection, or pneumonia. From existing positive microbiological and radiology reports, these patients were assessed for the presence of device-associated infection according to specified definitions. Of 1354 patients surveyed, 253 (19%) were receiving antimicrobial for treatment; of these, 189 also had devices and 172 (only 13% of all patients surveyed) needed individual assessment for the presence of device-associated infection. It took about 5min per patient to check electronic microbiology and/or radiology reports. Twenty-three patients met the criteria for device-associated infection. The prevalence of catheter-associated urinary tract infection, central-line-associated bloodstream infection, local vascular access infection, and ventilator-associated pneumonia was 3.9%, 3.1%, 3.8% and 11.6%, respectively. This is a simple method, which can be adopted in other hospitals, to estimate the prevalence of device-associated infection using pre-existing data.