Healthcare-associated infections (HAIs) and antimicrobial use

These data are released as part of the third point prevalence survey (PPS-3) of healthcare-associated infections (HAIs) and antimicrobial use in acute care hospitals, coordinated by ECDC in 2022-2023. See the new report from ECDC.

Iceland’s Participation

Iceland participated in all three surveys conducted in 2010–2011, 2016–2017, and now. As in the previous two PPS studies, data was collected at the two largest hospitals in Iceland, Landspítali University Hospital and Akureyri Hospital, in collaboration with the Chief Epidemiologist. In PPS-3, COVID-19 infections and infections originating outside the hospitals, were added to the study protocol. The results of PPS-3 are, therefore, not entirely comparable to those of the first two PPS studies.

Main Outcomes

In Iceland, the proportion of patients with HAIs in PPS-3 was 6.2%, somewhat lower than in most EU/EEA countries, where the average was 7.1%.

The proportion of HAIs caused by bacteria resistant to important antibiotics in Iceland was 8.3%, again low compared to many EU/EEA countries (average 29.6%). The high proportion of bacteria resistant to important antibiotics is a particular concern as it limits the options for treating infected patients.

The proportion of patients receiving antibiotics was 30.7% in Iceland, somewhat lower than in EU/EEA countries (average 36%). The use of antibiotics in EU/EEA countries increased somewhat compared to previous surveys, as the proportion was 32.9% in 2016–2017.

Respiratory tract infections, including pneumonia and COVID-19, accounted for nearly one-third of all HAIs, followed by urinary tract infections, surgical site infections, bloodstream infections, and gastrointestinal infections.

In 2022-2023, healthcare-associated COVID-19 significantly contributed to the increased burden of HAIs compared to the previous PPS in 2016-2017. SARS-CoV-2, the virus responsible for COVID-19, ranked as the fourth most common microorganism in HAIs. It should be noted that the proportion of COVID-19 among HAIs was considerably higher (11.4%) in the 11 countries that performed the survey in 2021 or 2022 than in the 18 countries that participated in 2023 (4.3%). This proportion was 0% in Iceland, where the survey was conducted in May 2023.

Infection Prevention and Control (IPC)

At least 20% of HAIs are preventable by sustained and multifaceted IPC programmes. IPC measures are more effective when they are part of multimodal implementation strategies, combining elements such as education, monitoring and feedback.

Simple measures such as hand cleaning and positioning a hand sanitizer at patients' bedsides can significantly reduce infections. More comprehensive interventions, such as ensuring sufficient individual rooms and staff with expertise in infection prevention, also play an important role.

The Chief Epidemiologist

More details:

• ECDC news

• The full report (ECDC)

• Iceland's results