The European Centre for Disease Control estimates that 3.8 million people acquire a healthcare-associated infection each year in acute care hospitals in EU countries and Norway and Iceland (Suetens et al., 2018), and an estimated 90 000 people in the EU die each year due to the six most common infections in health care settings (Cassini, 2016). At least 20% of healthcare-associated infections are considered to be avoidable through better infection prevention and control (Harbath, 2003).
6.28 shows the percentage of patients reported by selected hospitals in EU countries to have acquired a healthcare-associated infection in 2016-17, together with the predicted percentage of patients that would be expected to have acquired such an infection based on patient characteristics. On average across EU countries (weighted), 5.5% of patients acquired an infection during their hospital stay in 2016-17. The observed percentage was lowest in Lithuania, Bulgaria, Germany, Latvia, the Netherlands and Romania (less than 4%), and highest in Greece, Portugal, Italy, Finland and Cyprus (more than 8%).
6.29 shows the proportion of healthcare-associated infections by type of care (specialty). Across EU countries, patients in medical specialty areas (including general medicine, cardiology, oncology, neurology) accounted for 40% of all infection cases in 2016-17. Patients in surgical specialty areas represented another 33% of cases, while intensive care patients accounted for 13% of infections. Geriatrics, paediatrics and other specialty areas made up the remaining 14% of healthcare-associated infections.
As shown in 6.30, the most common types of healthcare-associated infections were pneumonia (accounting for 26% of all cases), urinary tract infections (19%), surgical site infections (18%), bloodstream infections (11%) and gastrointestinal infections (9%).
Compounding the impact of healthcare-associated infections are infections due to antimicrobial resistant bacteria, which can lead to complications, longer hospital stays, or death. A single resistant infection has been estimated to cost about EUR 8 500 to 34 000 more than a non-resistant infection, due to additional hospital days and additional treatment costs (OECD, 2017). Inappropriate use of antibiotics contribute to antimicrobial-resistant bacteria in hospitals and in the community.
Healthcare-associated infections can be prevented by implementing a series of measures, as set out in the Council of the European Union’s Recommendation on Patient Safety, including the Prevention and Control of Healthcare-Associated Infections (2009/C 151/01). At the hospital level, key components of effective infection prevention and control strategies include: the creation of a local infection control team; staff training; use of evidence-based guidelines; infection surveillance and feedback; and rigorous maintenance of environmental hygiene (WHO, 2016). Most European countries have established their own national guidelines for infection control programmes (ECDC, 2018).
