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The COVID-19 pandemic led to unprecedented stress on healthcare systems worldwide, forming settings of concern for increasing antimicrobial resistance. We investigated the impact of SARS-CoV-2 preventive measures against healthcare-associated infections (HAIs) from antibiotic-resistant bacteria in two tertiary-care hospitals. We compared infection rates between March 2019 and February 2020 (pre-intervention period) and March 2020 and February 2021 (COVID-19 intervention period) from drug-resistant ESKAPEE bacteria (methicillin-resistant Staphylococcus aureus; vancomycin-resistant Enterococci; carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species and Escherichia coli). Over 24 months, 586 drug-resistant ESKAPEE HAIs occurred in 439 patients (0.3% of 179,629 inpatients) with a mean age of 63 years, with 43% being treated in intensive care units (ICUs), and having a 45% inpatient mortality rate. Interrupted time series analysis revealed increasing infection rates before the intervention that were sharply interrupted by abrupt drops for most pathogens and henceforth remained stable in the ICUs but progressively increased in ordinary wards. In the ICUs, the pooled infection rate was 44% lower over the intervention period compared to the pre-intervention period (incidence rate ratio (IRR) 0.56, 95%CI 0.41–0.75, p < 0.001). Pooled infection rates in the wards were slightly higher over the COVID-19 period (IRR 1.12, 95%CI 0.87–1.45, p = 0.368). The findings confirmed the ancillary beneficial impact of the enhanced bundle of transmission-based precautions adopted against SARS-CoV-2 in rapidly constraining antimicrobial-resistant HAIs in two Greek hospitals.

Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals.Cross-sectional survey.A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were as follows: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP.Although most HCPs supported mandatory vaccinations, significant vaccination gaps, and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella has increased in the past decade, mostly because of reduction in acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP's vaccination rates is urgently needed.

A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in nurses compared to physicians. Fears related to vaccine safety, lack of information and general knowledge about vaccinations, influenza vaccine acceptance, education level and years of practice were among the factors independently associated with vaccine acceptance. A strong association was identified between vaccination of HCWs in each health region and the population coverage, indicating that HCWs may be role models for the general population. Information campaigns should continue despite decisions taken regarding mandatory vaccinations.

Background To investigate intention rates to get vaccinated against COVID-19 among healthcare personnel (HCP) in Greece. Methods Cross-sectional survey. Results The response rate was 14.5%. Of 1521 HCP with a known profession, 607 (39.9%) were nursing personnel, 480 (31.6%) physicians, 171 (11.2%) paramedical personnel, 72 (4.7%) supportive personnel, and 191 (12.6%) administrative personnel. Overall, 803 of 1571 HCP (51.1%) stated their intention to get vaccinated while 768 (48.9%) stated their intention to decline vaccination. Most HCP (71.3%) who reported intent to get vaccinated noted contributing to the control of the pandemic and protecting their families and themselves as their reasons, while the most common reason for reporting intent to decline vaccination was inadequate information about the vaccines (74.9%), followed by concerns about vaccine safety (36.2%). Logistic regression analysis revealed that the probability of intending to get vaccinated increased with male gender, being a physician, history of complete vaccination against hepatitis B, history of vaccination against pandemic A (H1N1) in 2009–2010, belief that COVID-19 vaccination should be mandatory for HCP, and increased confidence in vaccines in general during the COVID-19 pandemic. The following factors were associated with a lower intention to get vaccinated: no vaccination against influenza the past season, no intention to get vaccinated against influenza in 2020–2021, and no intention to recommend COVID-19 vaccination to high-risk patients. Conclusion There is an urgent need to built safety perception towards COVID-19 vaccines and raise vaccine uptake rates by HCP, and thus to protect the healthcare workforce and the healthcare services.

Background: Hospital-acquired infections (HAIs) affect 6 in 100 patients in acute-care hospitals in Europe, but their burden on patients admitted with chronic lung disease (CLD) is not well documented. Aim: To assess the prevalence of HAIs and their impact on mortality 30 and 90 days after hospital admission in adult CLD patients. Methods: Cross-sectional study in a stratified cluster sample of 37 hospitals in Greece, June 2012. CLD was recorded as documented chronic obstructive pulmonary disease, bronchiectasis, or any structural lung disease. HAIs were identified using the European Centre for Disease Prevention and Control criteria. A 3-month follow-up was performed to record patient outcome. Multiple Cox regression estimated the hazard ratio (HR) of death adjusting for important baseline predictors of mortality. Results: 741 patients with CLD were identified: mean age 72±13 years, 68% men, in medical (64%) & surgical (21%) wards and intensive care units (11%). A total of 108 HAIs were recorded in 99 CLD-patients (weighted prevalence: 14.2%; 95% confidence interval (CI): 12.1-16.7%), including lower respiratory tract (57 cases; 53%), urinary tract (11 cases; 10%), bloodstream (10 cases; 9%) and other (30 cases; 28%) infections. Mortality rates at 30 and 90 days were 12% and 32% for patients with HAI and 5% and 8% for uninfected patients, respectively. Patients with HAI had an adjusted HR of 0.79 (95% CI: 0.47-1.35) and 1.31 (95% CI: 0.84-2.05) for death within 30 and 90 days, respectively, compared to those without HAI. Conclusion: CLD patients carry a substantial HAI burden which is mainly, but not exclusively, due to lower respiratory tract infections. Long-term mortality risk is substantial.

Carbapenem-resistant gram-negative bacteria (CRGNB, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa)) are important nosocomial pathogens in Greece.