Work

Healthcare-associated infections in five annual point prevalence surveys at a Chinese tertiary hospital: annual patterns, associated factors, and cumulative healthcare resource use

Year: 2026

Type: article

Abstract: Repeated point prevalence surveys (PPSs) can characterize healthcare-associated infections (HAIs) and inform infection prevention priorities. This study examined annual HAI patterns, associated factors, antimicrobial use, and cumulative healthcare resource use at the survey date in a Chinese tertiary hospital. Five annual PPSs were conducted from 2020 to 2024 using a repeated cross-sectional design. Patient-level trends were assessed using an exact Cochran-Armitage test and episode-level trends using Poisson regression. Factors associated with prevalent HAI were examined using multivariable logistic regression. Cumulative hospital stay and consumer price index-adjusted hospitalization costs were analyzed using generalized linear models with a gamma distribution and log link. Among 4,245 surveyed inpatients, 72 patients had 81 HAI episodes, corresponding to patient-level and episode-level prevalence estimates of 1.70% and 1.91%, respectively. Patient-level prevalence decreased from 2.99% in 2020 to 0.93% in 2024 (exact P = 0.001), and episode-level prevalence also declined (rate ratio per one-year increase, 0.735; 95% CI, 0.624–0.867; P < 0.001). Lower respiratory tract and urinary tract infections each accounted for 34.57% of episodes. Antimicrobial use decreased from 38.86% to 30.02% ( P for trend = 0.006). Indwelling urinary catheterization (OR, 12.827; 95% CI, 6.545–25.137) and central venous access device placement (CVAD) (OR, 2.223; 95% CI, 1.154–4.284) were associated with prevalent HAI, whereas surgery showed an inverse adjusted association (OR, 0.462; 95% CI, 0.241–0.883). HAI status was associated with adjusted mean ratios of 1.970 (95% CI, 1.616–2.402) for cumulative hospital stay and 2.013 (95% CI, 1.673–2.423) for hospitalization costs at the PPS date (both P < 0.001). Patient-level and episode-level HAI prevalence and antimicrobial use showed overall downward trends across the five annual PPSs. Indwelling urinary catheterization and CVAD placement were associated with prevalent HAI. These findings support continued surveillance of priority infection sites and strengthened management of invasive devices.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-14285-4

Authors: Jin Yao, Pingping Wang, Xinxin Wang, Dandan Wang, Xiaorong Huang

Institutions: Henan University of Science and Technology, Luoyang Institute of Science and Technology

Language: English

Topic: Infection Control in Healthcare

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090