Microbiology Testing Rates Low For Hospital-Acquired Infections

The European Centre for Disease Control and Prevention (ECDC) estimates that there are 9 million cases of health care-associated infections (HAIs) across Europe each year, according to a study presented at the European Congress of Clinical Microbiology & Infectious Diseases (Netherlands; April 13–16). The survey also reveals low microbiological testing rates that vary widely between countries.

“Our analysis shows that health care-associated infections still pose a major public health threat in European countries and health care institutions”, says Pete Kinross from the ECDC. “Culture-directed antibiotic treatment is an important aspect of the treatment and control of these kinds of infections. The variability of microbiological testing suggests poor availability of information for effective treatment, as well as alertness to potential outbreaks.”

The ECDC conducted point prevalence surveys of HAIs and antimicrobial use in both acute care hospitals and long-term care facilities in European Union and European Economic Area countries between 2016 and 2017. The voluntarily participating acute care hospitals and long-term care facilities reported on every patient or resident who was present on the day of the survey. Analysis included 310,755 patients from 1,209 acute care hospital in 28 countries and 117,138 residents from 1,798 long-term care facilities in 24 countries.

One in 15 patients in European acute care hospitals and one in 24 residents in European long-term care facilities have at least one infection on any given day. A microorganism was reported for just over half (53 percent) of the HAIs in acute care hospitals. Antimicrobial susceptibility testing results were not available on the day of the survey for 11 percent of the microorganisms reported. In long-term care facilities, only 19 percent of HAIs had a microbiological test result available to guide treatment and control.

There was great intra-country variability in testing rates, with rates lower in Hungary, Lithuania, and Romania and higher in Belgium, Finland, and the United Kingdom. Countries with lower testing rates detected fewer HAIs. The most common HAIs were respiratory tract infections (particularly pneumonia), accounting for one-fourth of all HAIs in hospitals and one-third in long-term care facilities, followed by urinary tract infections which accounted for one-fifth of hospital HAIs and one-third of long-term care HAIs.

Takeaway: More needs to be done to apply testing guidelines and recommendations in European hospitals and long-term care facilities to boost microbiology testing rates for detection of HAIs and potential outbreaks.