A study conducted by CINTESIS – Centre for Health Technology and Services Research/Faculty of Medicine of the University of Porto (FMUP) has identified consistent regional patterns in the incidence of hospital-acquired infections in Portuguese hospitals over a four-year period.
The team, led by Hugo Teixeira, a CINTESIS researcher, concluded that from 2014 to 2017, Portugal recorded 318,000 hospitalizations with at least one hospital-acquired infection. 16% of the hospitalized patients died during their hospital stay.
Entitled “Spatial Patterns in Hospital-Acquired Infections in Portugal (2014-2017)” and published in the International Journal of Environmental Research and Public Health, the paper describes the spatial patterns of hospital-acquired infections in children, adults, and the elderly, namely infections related to the use of a central catheter, Clostridium difficile intestinal infections, hospital-acquired pneumonia, surgical site infections, and urinary tract infections. For this, the research team used a methodology based on the use of Geographic Information Systems (GIS), which can contribute to better surveillance of hospital infections.
The Center region systematically showed the highest rates of hospitalizations due to hospital infections. The South was the region with the lowest rates. Geographic disparities were maintained throughout the years analyzed, regardless of the age of the patients.
According to the authors, “hospital infections are not randomly distributed in space, since high-risk clusters were always observed in the center of the country. These results may be useful to support new and better health policies, as well as to promote a review of guidelines for Infection Control Committees,” warns the CINTESIS researcher, who recently completed his PhD in Clinical Research and Health Services at the FMUP.
The median hospital stay was 9 days. Pneumonia was the most frequent hospital infection. The peak occurred in 2015, with 81,690 cases. In that year, this type of hospitalizations accounted for almost 10% of the total.
The elderly were the age group with the most hospitalizations due to hospital infections in Portugal, accounting for 77% of the total. Adults (aged 19 to 64) accounted for 18% and children, only 4.7%. Length of hospitalization is also higher among the elderly. The median number of days of hospitalization ranges from six days for young people to 10 days for adults and the elderly.
Hospital infections are the most frequent adverse event associated with health care, resulting in prolonged hospital stays and high mortality worldwide. Given the increase in hospital infections, the FMUP researcher believes that techniques based on Geographic Information Systems should be “replicated in other hospitals” for early identification of patterns, trends or clusters of infections, thus allowing “triggering the teams” and “increasing patient safety”.
Hugo Teixeira’s work was funded by the Portuguese Foundation for Science and Technology (FCT), with the participation of other researchers from the Faculty of Medicine of the University of Porto, namely Alberto Freitas, António Sarmento and Hernâni Gonçalves, as well as Paulo Nossa, from the University of Coimbra, and Maria de Fátima Pina, from the Oswaldo Cruz Foundation/Institute for Communication and Scientific and Technological Information on Health in Brazil.