Burden of healthcare-associated infections in Italy:incidence, attributable mortality and disability-adjusted life years (DALYs) from a nationwide study,2016

Background:Healthcare-associated infections (HAIs) are an increasing public healththreat. Measuring disease burden in disability-adjusted life-years (DALYs) allows thecombination of morbidity and mortality into one figure, as it represents the summation ofyears lived with disability and years of life lost.Aim:To evaluate the incidence, attributable deaths and burden of the most significantHAIs in Italy.Methods:Prevalence data from the study sample of the 2016 national Point PrevalenceSurvey of HAIs in acute-care settings were used to estimate the incidence of five HAIs. Themethodology from the Burden of Communicable Diseases in Europe (BCoDE)-project wasemployed for DALY calculations, adapting the disease models to the Italian population.Findings:We estimated a total of 641,065 (95% uncertainty interval, UI 585,543.00e699,207.90) new yearly cases of HAIs and 29,375 (95% UI 23,705.97e35,905.80) deaths inItaly in 2016. The total annual DALYs were estimated to be 424,657.45 (95% UI 346,240.35e513,357.28), corresponding to 702.53 DALYs (95% UI 575.22e844.66) per 100,000 generalpopulation. Bloodstream infections accounted for the majority of total DALYs (59%),healthcare-associated pneumonia for 29%, surgical site infections for 9%, CDI for 2% andurinary tract infections accounted for less than 1% of total DALYs.Conclusion:Results of this study suggest HAIs have a substantial burden in Italy. Reducingthe burden of HAIs through infection prevention and control efforts is an achievable goal.This study provides data that could be used to guide policy-makers in the implementationof these measures