Prevention of healthcare-associated infections (HAIs) in a surgical urology ward: observational study-analysis of the problem and strategies for implementation

World J Urol. 2020 Jan;38(1):3-8. doi: 10.1007/s00345-019-02648-3. Epub 2019 Jan 30.

Abstract

Purpose: Our purpose is to present the results of our working group, with a view to reduce the incidence and improve the management of healthcare-associated infections (HAIs) in a urology ward.

Methods: The study consists on an observational database designed with the view to analyse the incidence and characteristics of HAIs in Urology. Based on the results obtained, a critical evaluation was carried out and specific measures put in place to reduce HAIs. Finally, the impact and results of the implemented measures were periodically evaluated.

Results: The incidence of HAIs in urology decreased from 6.6 to 7.3% in 2012-2014 to 5.4-5.8% in 2016-2018. In patients with immunosuppression the incidence of HAIs decreased from 12.8 to 18% in 2012-2013 to 8.1-10.2% in 2017-2018, in those with a previous urinary infection fell from 13.6 to 4.8%, in those with a urinary catheter prior to admission from 12.6 to 10.8%, and in patients with a nephrostomy tube from 16 to 10.9%. The effect of the protocol also demonstrated a reduction in the percentage of patients with suspicion of HAIs for whom no culture was taken, from 6% in 2012 to zero in 2017 and 2018. Moreover, the implementation of protocols for empirical treatment has reduced the incidence of patients experiencing inadequate empirical antimicrobial therapy from 20 to 8.1%.

Conclusion: It is essential to monitor the incidence of HAIs, and preventive measures play a useful role in reducing the rate of infection and in optimising their management.

Keywords: Antibiotic resistance; Healthcare-associated infection (HAI); Surgical site infection (SSI); Urinary tract infection (UTI); Urology Department.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Practice Guidelines as Topic*
  • Retrospective Studies
  • Spain / epidemiology
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / prevention & control*
  • Urologic Surgical Procedures*