Burden of Healthcare-Associated Infections in Italy: incidence, attributable mortality and Disability-Adjusted Life Years (DALYs) from a nationwide study, 2016.

Abstract Background Healthcare-associated infections (HAIs) are an increasing public health threat. Measuring disease burden in disability adjusted life-years (DALYs) allows to combine morbidity and mortality in one figure, as it represents the summation of years lived with disability and years of life lost. Aim To evaluate the incidence, attributable deaths and burden of the most significant HAIs in Italy. Methods Prevalence data from the study sample of the 2016 national national Point Prevalence Survey of HAIs in acute-care settings were used to estimate the incidence of five HAIs. The methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project was employed for DALY calculations, adapting the disease models to the Italian population. Findings We estimated a total of 641,065 (95% uncertainty interval, UI 585,543.00 – 699,207.90) new yearly cases of HAIs and 29,375 (95% UI 23,705.97 – 35,905.80) deaths in Italy in 2016. The total annual DALYs were estimated to be 424,657.45 (95% UI 346,240.35 – 513,357.28), corresponding to 702.53 DALYs (95% UI 575.22 – 844.66) per 100,000 general population. BSI accounted for the majority of total DALYs (59%), HAP for 29%, SSI for 9%, CDI for 2% and UTI accounted for less than 1% of total DALYs. Conclusion Results of this study suggest HAIs have a substantial burden in Italy. Reducing the 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 implementation of these measures.