English summary: Estimating the burden of healthcare-associated infections caused by selected multidrug-resistant bacteria in Finland in 2011

Background

Knowledge of the burden of healthcare-associated infections (HAIs) and antibiotic resistance is important for resource allocation in infection control. Although national surveillance networks do not routinely cover all HAIs due to multidrug-resistant bacteria, estimates are nevertheless possible: in the EU, 25,000 patients die from such infections annually. We assessed the burden of HAIs due to multidrug-resistant bacteria in Finland in 2011.

Methods

By combining data from the National Infectious Disease Registry on the numbers of cases of bacteraemia caused by Staphylococcus aureus, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter spp., and susceptibility data from the National Antimicrobial Resistance Network and the Finnish Hospital Infection Programme, we assessed the numbers of healthcare-associated bacteraemia cases due to selected multidrug-resistant bacteria. We estimated the number of pneumonia cases, surgical site infections and urinary tract infections on the basis of the ratio of these infections in the national prevalence survey for HAI in 2011. Attributable HAI mortality (3.2%) was derived from the national prevalence survey in 2005.

Results

The estimated annual number of the most common HAIs due to the selected multidrug-resistant bacteria was 2412 (455 HAIs per million), 5% of all HAIs in Finnish acute care hospitals. The number of attributable deaths was 77 (16 per million).

Discussion

Resources for infection control should be allocated not only to screening and isolation of carriers of multidrug-resistant bacteria, but also to preventing all clinical infections regardless of the resistance pattern.