Trends in Healthcare-Associated Infections and Antimicrobial Use in a Paediatric Hospital from Bucharest, Romania, Across the Pre-Pandemic, Pandemic, and Post-Pandemic Periods (2017–2024)

Abstract

The COVID-19 pandemic and the broader epidemiological context may have affected healthcare-associated infections (HAIs) and antimicrobial use (AU), including among the paediatric population. This study used seven point prevalence surveys (PPSs) to characterise HAIs and AU and to observe trends over time at a paediatric hospital in Bucharest. We collected data from 977 patients and identified 31 HAIs in 28 patients with an overall prevalence of 2.9%. During the COVID-19 years, prevalence was higher (4.0%), but no trend was detected. Variables such as surgical ward (aOR: 4.88; CI: 1.63–14.59; p = 0.012) and age (aOR: 0.89; CI: 0.81–0.97; p = 0.012) were associated with HAI occurrence. AU prevalence was 72.6%, with no specific trend across the study period (p = 0.48) overall or by ward. Most prescribed antibiotics were from the Watch category (65.5%), with an upward trend across the study period (p < 0.0001), while the Access category registered a downward trend. In conclusion, HAI prevalence did not vary significantly with the epidemiological context. Antibiotic use in the Watch category increased during the pandemic, while the Access category declined. These findings highlight the importance of surveillance for infection prevention and control at the hospital level, and the need for antimicrobial stewardship, guidelines, and continuing medical education on appropriate prescribing practices in paediatric care.