1380. Healthcare-Associated Clostridium difficile Infections in the National Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Acute Care Hospitals in Hungary, 2012
Session: Poster Abstract Session: Clostridium difficile
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • IDWeek poster_CDI HUN_final version_HAJDU.pdf (672.9 kB)
  • Background:

    To estimate the burden of healthcare-associated infections (HAI) and antimicrobial use in acute care hospitals in Hungary, a national point prevalence survey (PPS) was conducted in May 2012. Since mandatory notification data suggest that the incidence of healthcare-associated Clostridium difficile infection (HA-CDI) has doubled from 2011 to 2012 in the country, we aimed to describe HA-CDI cases and identify factors associated with HA-CDI in the national PPS.


    In the national survey, a representative sample of all Hungarian acute care hospitals was enrolled; the PPS protocol and case definitions of the European Centre for Disease Prevention and Control (ECDC) were used. We calculated mean prevalence of HA-CDI, and prevalences by hospital, specialty, age and sex. Multiple logistic regression was used to determine factors associated with HA-CDI.  


    Twenty-nine hospitals and 10,180 patients were included in the national PPS. A total of 462 patients with HAI (4.5%, 95% CI: 4.0-5.2%) and 498 HAIs were recorded. The mean prevalence of HA-CDI was 0.5% (95% CI: 0.3-0.9, 53/10,180), with variation across hospitals (0-1.8%). Almost half of HA-CDIs (47.3%) were present on admission. The highest HA-CDI prevalences were found in infectious diseases (13/122, 10.7%), medical intensive care (1/40, 2.5%) and gastroenterology (9/389, 2.3%) specialties. Prevalence of HA-CDI increased with age (0.1% <40y vs 1.2% ≥75y of age), and did not differ by sex. Of the 53 HA-CDI cases identified, in 44 cases oral metronidazole/vancomycin, in 5 cases parenteral metronidazole/vancomycin, and in 4 cases other antimicrobials were used on the survey day. Medical specialty, secondary or tertiary level of care, urinary catheter in place, ultimately or rapidly fatal co-morbidity, increasing age and length of stay (before onset, if infection) were independently associated with increased odds of HA-CDI.


    The percentage of HA-CDI among all HAIs was considerably higher in Hungary (10.6%) than in the overall European PPS (3.6%). In Hungary, elderly with underlying diseases in medical wards seem to be at highest risk of HA-CDI. The burden of imported cases was important, therefore prevention efforts should specifically target screening of diarrhoeal patients with history of recent stay in a healthcare facility.

    Agnes Hajdu, MD, Andrea Kurcz, MD and Karolina Böröcz, MD, MSc, Hospital Epidemiology and Hygiene, National Center for Epidemiology, Budapest, Hungary


    A. Hajdu, None

    A. Kurcz, None

    K. Böröcz, None

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