P14. Pilot study of electronic HAI surveillance with ward physician involvement in seven critical wards of a hospital in Rome

Surveillance of healthcare-associated infections (HAIs) is vital for infection control programmes (ICPs). In acute care hospitals, it should ideally cover all wards, specialties, and infection types. Traditional methods are labour-intensive, but electronically assisted surveillance systems (EASSs) can enhance efficiency. This study presents preliminary data from an EASS implemented at Policlinico Tor Vergata, Rome.

Since 2024, an online platform for HAI surveillance has been active in six critical wards. A positive microbiological test after 48 hours of admission triggers an alert, prompting an eight-question survey to identify the infection type: bloodstream infections (BSIs), pneumonia (HAP/VAP), urinary tract infections (UTIs), surgical site infections (SSIs), or gastrointestinal infections (GIs) (e.g. Clostridioides difficile). Trained ward physicians validate survey responses. The platform provides real-time prevalence data, correlated with metrics like length of stay, antibiotic use, and hand hygiene compliance, to inform antimicrobial stewardship strategies.

From January to June 2024, 1021 alerts were generated; 349 infections were confirmed after excluding duplicates and non-infections. Of these, 198 were HAIs: BSIs (35%), UTIs (24%), SSIs (16%), HAP/VAP (15%), and GIs (10%). In haematology, BSIs predominated, especially in haematopoietic stem cell transplantation (100%), lymphoproliferative (46%), and myeloproliferative (87%) units. In ED-ICU, HAP/VAP (67%) and UTIs (15%) were most common. In infectious diseases, BSIs (32%) and UTIs (31%) were frequent, while SSIs (56%) dominated in solid organ transplant surgery. In cardiac surgery, BSIs and UTIs accounted for 40% of HAIs. Of the 198 HAIs, 34 were polymicrobial. Gram-negative infections (45%) exceeded gram-positive ones (39%). Fungal infections (Candida spp.) accounted for 9%, and Clostridioides difficile for 7%. Pseudomonas aeruginosa (24.7%), Klebsiella pneumoniae (33.9%), and Escherichia coli (19.2%) were the most common gram-negative pathogens, with 34% resistant to meropenem. Coagulase- negative staphylococci (27%), Enterococcus faecium (26%), and Staphylococcus aureus (19.7%) were the leading gram-positive pathogens, with oxacillin resistance at 62% (Staphylococcus spp.) and vancomycin resistance at 36% (Enterococcus spp.).

EASSs simplify HAI data collection and, combined with physician involvement, improve surveillance and inform ICP strategies.