Risk factors for healthcare-associated infections: a single-centre study in a university hospital

Abstract

Purpose: Healthcare-associated infections (HAIs) are a constantly growing problem in contemporary health care. This research attempts to determine risk factors for HAIs in one ward of a university hospital. Materials and methods: The study included 631 inpatients hospitalized between 2017 and 2018 who had been assigned an even number for their medical record when they were admitted, and who gave informed consent to participate in the study. The following were assessed for each patient included in the study: demographic, clinical and anthropometric data; parameters of body composition; biochemical parameters; functional status (e.g., activities of daily living [ADL] and Norton scale scores); nutritional risk score (NRS-2002); comorbidity scale scores (Charlson Comorbidity Index and Cumulative Illness Rating Scale); and ATLAS scale score. Remote follow-up was conducted by telephone interview after 14, 30, 90, and 365 days. Results: The prevalence of HAIs was 17.9%. The occurrence of HAIs was shown to be more strongly related to iatrogenic factors (e.g., urine bladder catheterization [UBC] or central venous cannulation [CVC]) than to the ‘patient-dependent’ factors included in commonly used HAI risk scales. The ‘Czerniak-score,’ which extends the ATLAS score to include comorbidity analysis, the patient’s functional status, and the need for CVC or UBC, allows the identification of a significant majority of patients at risk (≥ 3 points) and not at risk ( < 3 points) of HAI, with 82.2% sensitivity, 94.02% specificity, a positive predictive value of 74.17%, and a negative predictive value of 95.68%. Conclusions: Holistic HAI risk stratification included in the Czerniak-score can identify the majority of patients at risk (≥ 3 points) of HAI.