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
Posters
  • 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.

    Methods:

    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.  

    Results:

    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.

    Conclusion:

    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

    Disclosures:

    A. Hajdu, None

    A. Kurcz, None

    K. Böröcz, None

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