Background and objective:
Healthcare-associated infections (HAIs) represent the most frequent adverse event in the hospital setting. As part of a surveillance study promoted by the European Centre for Disease Control and Prevention, a survey was carried out to estimate HAIs prevalence in an acute care hospital in central Italy.

Methods:
The investigation was carried out in November 2022 through the anonymous consultation of clinical records, using a standardized protocol to collect data on patients, wards, HAIs, and antibiotic therapy.

Results:
A total of 164 patients (51.2% males; aged 0-94 years) hospitalized in 17 different wards were included, and 57.3% were in medical wards. At time of the survey, 10.4% (n=17) patients had at least one HAI (53% female; mean age 68.4 years), and 94% were hospitalized in medical wards. 64.7% of infections were linked to inpatient hospital, 23.5% to a long-term care facility and 11.8% to another hospital. According to McCabe score, HAIs patients were mostly (47.1%) classified as with non-fatal disease, while 23.5% and 29.4% with fatal and rapidly fatal disease, respectively. 82.4% of HAIs patients had at least one device (central venous and bladder catheter, tracheal cannula), and 21.4% and 14.3% carried two and three devices, respectively. Furthermore, 82.4% were treated with at least one antibiotic, with two and three antibiotics used simultaneously in 21.4% and 14.3%. A microbiological isolation with antibiogram was present only in 41.2%.

Conclusion:
HAIs prevalence was higher than 8.2% estimated for Italian hospitals in 2016-2017 survey and 7.5% assessed in the same hospital in 2019. A significant role for HAIs onset was associated with invasive devices, ward specialty, and severity of clinical conditions. These findings underline the need to strengthen programs for HAIs control through the definition of standardized protocols and availability of specialized team, also in terms of human resources and skills.