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Hospital acquired infections: Low use of molecular testing in Europe

Hospital acquired infections are a major public health problem. According to a recently published study, approximately 2.6 million patients are estimated to acquire a healthcare-associated infection (HAI) in form of multi-drug resistant organisms in the EU each year.

The number of deaths occurring as a direct consequence of these infections is estimated to be at least 91,000. The study included six of the most common HAI's: healthcare-associated pneumonia (HAP), healthcare-associated urinary tract infection (HA UTI), surgical site infection (SSI), healthcare-associated C. difficile infection (HA CDI), healthcare-associated neonatal sepsis, and healthcare-associated primary bloodstream infection (HA primary BSI). (Cassini et al, 2016:2)

These alarming numbers do not only depend on treatment but also on surveillance control and testing methods. Molecular testing methods shorten the time to result, which is a crucial factor for targeted treatment and appropriate hygiene control mechanisms in order to prevent a spread of the disease to other patients. According to a recent EU study by data information intelligence, in 2016 220 clinical laboratories in Germany used molecular methods for close to 500,000 MRSA tests per year – less than in 2014. For MRSA, bacterial culture is still the dominant screening method, and positive samples are sent out for confirmation to microbiology laboratories. Only 100,000 molecular tests were conducted for C. difficile, VRE, ESBL and Carpa-R. In Germany, growth in molecular test volume has only been seen for C. difficile and VRE. The study also showed that other European countries had even lower numbers of molecular MRSA testing in 2016: In Italy only 21 clinical laboratories used molecular methods with a total of ~6,000 tests per year and in France 103 clinical laboratories conducted ~200,000 tests per year.

A further improvement of surveillance control and fast testing methods are necessary, since dealing with the danger and costs of hospital acquired infections is one of the most challenging problems in public health care.

Sources:

data information intelligence (dii) study: The Continuous Molecular Market Assessment is an independent research study aimed at providing periodic, accurate and granular information for the European routine molecular diagnostic market.
The survey was conducted in around 500 hospital and independent labs in 8 European countries and delivers data on 39 different NA tests by test type and laboratory segment.

Cassini et al, Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study, Geneva 2016

written by Isabelle Donner, data information intelligence