Epidemiology of healthcare-associated infections in Australia: New data and challenges
Professor Ramon Z. Shaban1,2,3,4, Professor Brett G. Mitchell5, Associate Professor Philip L. Russo6, Dr Deborough Macbeth7
1Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, Australia
2Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, Australia
3Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, Australia
4New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, , Australia
5School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia
6Department of Nursing Research, Cabrini Education and Research Precinct, Monash University, Frankston, Australia
7Department of Infection Control, Gold Coast University Hospital, Gold Coast, Australia
Introduction: Healthcare-associated infections (HAIs) are a major patient safety problem and lead to increased morbidity, mortality and excess healthcare expenditure. While surveillance is central to all efforts to control and prevent HAIs, there is no single unified national HAI surveillance system in Australia.
Methods: In an attempt to collate the available data on the epidemiology of HAIs in Australia, three types of HAIs were included: (i) proportions of HAI hospital-acquired complication (HAI HAC) in Australian public hospitals (1st July 2017-30th June 2019); (ii) publicly available Australian jurisdictional surveillance data (2017-2019); and (iii) peer-reviewed literature data (1st January 2010-31st August 2019).
Results: Proportions of HAI HAC data for each HAI remained stable over 2017-2019, with 75-80% of each HAI occurring in NSW, VIC and QLD. Staphylococcus aureus bacteraemia was the only HAI data reported nationally and by all jurisdictions. A benchmark of 2.0 cases/10,000 patient days was established, and in 2018-19 all jurisdictions reported rates below the benchmark. A 2017 systematic review of the burden of HAI in Australian hospitals suggested there were 83,096 HAIs/year in Australia. Two national point prevalence studies of HAI in Australia have been conducted, with latest 2018 study indicating an overall HAI prevalence of patients with a HAI of 9.9%.
Conclusion: This is the first attempt to collate the available data regarding the epidemiology of HAIs in Australia. Findings will provide hospitals infection prevention and control units an opportunity to benchmark and evaluate interventions to reduce infections and provide transparency on infection rates in hospitals.
Professor Shaban is the Inaugural Clinical Chair and Professor of Infection Prevention and Disease Control in Sydney Nursing School & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney and Western Sydney Local Health District. He has extensive inter-professional expertise in infectious diseases, infection control and emergency care.