Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 10 January 2025 | Viewed by 3573

Special Issue Editor


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Guest Editor
Department of Public Health, School of Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
Interests: healthcare associated infections (HAIs); molecular epidemiology of healthcare-associated infections; epidemiology of antimicrobial resistance; disinfectant tolerance; carbapenem resistant (CR) Acinetobacter baumannii; third generation cephalosporins and carbapenem resistant Enterobacterales
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Special Issue Information

Dear Colleagues,

Healthcare-associated infections (HAIs) are infections acquired while patients receive treatment for medical or surgical conditions. The widespread misuse of antibiotics has led to the emergence of multidrug-resistant bacteria, which are responsible for most HAIs. HAIs are associated with increased morbidity and mortality, prolonged hospital stays, and greater healthcare costs. Surveillance of HAIs is important to measure their burden, identify high-risk populations and procedures, and guide efforts to reduce HAI incidence. HAI surveillance is a core component of infection prevention and control (IPC) programmes worldwide. IPC is a practical, evidence-based approach preventing patients and health workers from being harmed by avoidable infections. IPC involves all aspects of healthcare, including antimicrobial resistance. The frequency of HAIs varies between countries and according to economic conditions. The risk of acquiring an HAI is up to 20 times higher in low-/middle-income countries (LMICs). Interestingly, in a global survey, the prevalence of resistance to antibiotics, including for carbapenems against Enterobacterales, Acinetobacter spp., and Pseudomonas spp., was significantly higher in LMICs. Effective IPC requires constant action at all levels of the health system, particularly in LMICs, from policymakers, facility managers, health workers and those who access health services.

For this Special Issue we invite you to submit a manuscript related to all aspects concerning HAI detection, control and management.

Dr. Maria Bagattini
Guest Editor

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Keywords

  • healthcare-associated infections (HAIs)
  • infection prevention and control
  • antimicrobial resistance
  • HAIs management and control
  • carbapenem resistant (CR) Enterobacterales
  • carbapenem resistant (CR) Acinetobacter baumannii

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Published Papers (2 papers)

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Research

15 pages, 1226 KiB  
Article
Incidence and Predictors of Healthcare-Associated Infections in Patients Admitted to a Temporary Intensive Care Unit during the COVID-19 Pandemic Waves: A Two-Year (2021–2023) Retrospective Cohort Study in Rome, Italy
by Antonio Sciurti, Valentina Baccolini, Mariateresa Ceparano, Claudia Isonne, Giuseppe Migliara, Jessica Iera, Francesco Alessandri, Giancarlo Ceccarelli, Carolina Marzuillo, Guglielmo Tellan, Maria De Giusti, Francesco Pugliese, Paolo Villari and the Collaborating Group
Antibiotics 2024, 13(9), 842; https://doi.org/10.3390/antibiotics13090842 - 4 Sep 2024
Viewed by 1102
Abstract
To manage the number of critical COVID-19 patients, Umberto I Teaching Hospital in Rome established a temporary ICU on March 1, 2021. This study investigated the incidence and risk factors of healthcare-associated infections (HAIs) among these patients during various COVID-19 waves. Patients were [...] Read more.
To manage the number of critical COVID-19 patients, Umberto I Teaching Hospital in Rome established a temporary ICU on March 1, 2021. This study investigated the incidence and risk factors of healthcare-associated infections (HAIs) among these patients during various COVID-19 waves. Patients were grouped by admission date according to the dominant SARS-CoV-2 variant prevalent at the time (Alpha, Delta, Omicron BA.1, Omicron BA.2, Omicron BA.5, and Omicron XBB). First-HAI and mortality rates were calculated per 1000 patient-days. Predictors of first-HAI occurrence were investigated using a multivariable Fine–Gray regression model considering death as a competing event. Among 355 admitted patients, 27.3% experienced at least one HAI, and 49.6% died. Patient characteristics varied over time, with older and more complex cases in the later phases, while HAI and mortality rates were higher in the first year. Pathogens responsible for HAIs varied over time, with first Acinetobacter baumannii and then Klebsiella pneumoniae being progressively predominant. Multivariable analysis confirmed that, compared to Alpha, admission during the Omicron BA.1, BA.2, BA.5, and XBB periods was associated with lower hazards of HAI. Despite worsening COVID-19 patient conditions, late-phase HAI rates decreased, likely due to evolving pathogen characteristics, improved immunity, but also better clinical management, and adherence to infection prevention practices. Enhanced HAI prevention in emergency situations is crucial. Full article
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12 pages, 900 KiB  
Article
Sequential or Combination Treatments as Rescue Therapies in Immunocompromised Patients with Persistent SARS-CoV-2 Infection in the Omicron Era: A Case Series
by Bianca Maria Longo, Francesco Venuti, Alberto Gaviraghi, Tommaso Lupia, Fabio Antonino Ranzani, Andrea Pepe, Laura Ponzetta, Davide Vita, Tiziano Allice, Vanesa Gregorc, Pio Manlio Mirko Frascione, Francesco Giuseppe De Rosa, Andrea Calcagno and Stefano Bonora
Antibiotics 2023, 12(9), 1460; https://doi.org/10.3390/antibiotics12091460 - 19 Sep 2023
Cited by 4 | Viewed by 1869
Abstract
Prolonged SARS-CoV-2 infections are widely described in immunosuppressed patients, but safe and effective treatment strategies are lacking. We aimed to outline our approach to treating persistent COVID-19 in patients with immunosuppression from different causes. In this case series, we retrospectively enrolled all immunosuppressed [...] Read more.
Prolonged SARS-CoV-2 infections are widely described in immunosuppressed patients, but safe and effective treatment strategies are lacking. We aimed to outline our approach to treating persistent COVID-19 in patients with immunosuppression from different causes. In this case series, we retrospectively enrolled all immunosuppressed patients with persistent SARS-CoV-2 infections treated at our centers between March 2022 and February 2023. Patients received different sequential or combination regimens, including antivirals (remdesivir, nirmatrelvir/ritonavir, or molnupiravir) and/or monoclonal antibodies (mAbs) (tixagevimab/cilgavimab or sotrovimab). The main outcome was a complete virological response (negative SARS-CoV-2 RT-PCR on nasopharyngeal swabs) at the end of treatment. Fifteen patients were included as follows: eleven (11/15; 73%) with hematological disease and four (4/15; 27%) with recently diagnosed HIV/AIDS infection. Six patients (6/15; 40%) received a single antiviral course, four patients (4/15; 27%) received an antiviral and mAbs sequentially, and two patients (13%) received three lines of treatment (a sequence of three antivirals or two antivirals and mAbs). A combination of two antivirals or one antiviral plus mAbs was administered in three cases (3/15, 20%). One patient died while still positive for SARS-CoV-2, while fourteen (14/15; 93%) tested negative within 16 days after the end of treatment. The median time to negativization since the last treatment was 2.5 days. Both sequential and combination regimens used in this study demonstrated high efficacy and safety in the high-risk group of immunosuppressed patients. Full article
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