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2. Establishing nationally representative central line-associated bloodstream infection surveillance data for paediatric patients in Greece

Author

Papaevangelou, V., Triantafyllidou, P., Fanaraki, E., Kaisari, K., Kalabalikis, P., Karachristou, K., Katsibardi, K., Kattamis, A., Kazantzi, M., Kitra, V., Lourida, A., Mpouza, E., Papadopoulou, S., Petrikkos, L., Polychronopoulou, S., Siahanidou, T., Zannikos, K., Giannopoulos, A., Hatzipantelis, E., Tragiannidis, A., Goumperi, S., Sdougka, M., Lithoxopoulou, M., Soubasi, V., Baka, M., Dimolitsa, C., Doganis, D., Kapetanakis, I., Mavrogeorgos, G., Nika, A., Papachristidou, S., Papadatos, I., Tsintoni, A., Baroutis, G., Stratiki, E., Skordala-Riti, M., Tsouvala, E., Gaitana, C., Grivea, I., Kaffe, A., Giapros, V., Gouvias, T., Drougia, A., Theodoraki, M., Karavana, G., Koropouli, M., Thomou, C., Kapetanaki, A., Tzaki, M., Maistreli, S., Kouni, S., Tsolia, M., Roilides, E., Dimitriou, G., Tsiodras, S., Skoutelis, A., Kourkouni, E., Gkentzi, D., Iosifidis, E., Spyridis, N., Kopsidas, I., Karakosta, P., Tsopela, G.C., Spyridaki, I., Kourlaba, G., Coffin, S., and Zaoutis, E.T.

Published
2019
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4. Establishing nationally representative central line-associated bloodstream infection surveillance data for paediatric patients in Greece

Author

Kouni, S. Tsolia, M. Roilides, E. Dimitriou, G. Tsiodras, S. Skoutelis, A. Kourkouni, E. Gkentzi, D. Iosifidis, E. Spyridis, N. Kopsidas, I. Karakosta, P. Tsopela, G.C. Spyridaki, I. Kourlaba, G. Coffin, S. Zaoutis, E.T. Papaevangelou, V. Triantafyllidou, P. Fanaraki, E. Kaisari, K. Kalabalikis, P. Karachristou, K. Katsibardi, K. Kattamis, A. Kazantzi, M. Kitra, V. Lourida, A. Mpouza, E. Papadopoulou, S. Petrikkos, L. Polychronopoulou, S. Siahanidou, T. Zannikos, K. Giannopoulos, A. Hatzipantelis, E. Tragiannidis, A. Goumperi, S. Sdougka, M. Lithoxopoulou, M. Soubasi, V. Baka, M. Dimolitsa, C. Doganis, D. Kapetanakis, I. Mavrogeorgos, G. Nika, A. Papachristidou, S. Papadatos, I. Tsintoni, A. Baroutis, G. Stratiki, E. Skordala-Riti, M. Tsouvala, E. Gaitana, C. Grivea, I. Kaffe, A. Giapros, V. Gouvias, T. Drougia, A. Theodoraki, M. Karavana, G. Koropouli, M. Thomou, C. Kapetanaki, A. Tzaki, M. Maistreli, S. the PHIG Investigators

Abstract

Background: Healthcare-associated infections (HCAIs) are associated with increased morbidity and mortality and with excess costs. Central line-associated bloodstream infections (CLABSIs) are the most common HCAIs in neonates and children. Aim: To establish national benchmark data for rates of CLABSI in neonatal and paediatric intensive care units (NICUs and PICUs) and paediatric oncology units (ONCs). Methods: Active surveillance for CLABSI was conducted from June 2016 to February 2017. A collaborative of 14 NICUs, four PICUs, and six ONCs participated in the programme. Surveillance definitions of central line (CL), central line utilization (CLU) ratio, CLABSI event, and CLABSI rate were based on the Centers for Disease Control and Prevention's 2014 National Healthcare Safety Network criteria. Medical records were assessed daily for calculating CL-days, patient-days, and susceptibility of isolated organisms. Findings: A total of 111 CLABSI episodes were recorded. The overall mean CLABSI rate was 4.41 infections per 1000 CL-days, and the CLU ratio was 0.31. CLABSI rates were 6.02 in NICUs, 6.09 in PICUs, and 2.78 per 1000 CL-days in ONCs. A total of 123 pathogens were isolated. The most common pathogens were Enterobacteriaceae (36%), followed by Gram-positive cocci (29%), non-fermenting Gram-negative bacteria (16%), and fungi (16%). Overall, 37% of Gram-negative pathogens were resistant to third-generation cephalosporins and 37% to carbapenems. Conclusion: Nationally representative CLABSI rates were determined for paediatric patients. These data could be used to benchmark and serve as baseline data for the design and evaluation of infection control and antimicrobial stewardship interventions. © 2018 The Healthcare Infection Society

Published
2019

5. Establishing nationally representative central line-associated bloodstream infection surveillance data for paediatric patients in Greece

Author

Kouni, S., primary, Tsolia, M., additional, Roilides, E., additional, Dimitriou, G., additional, Tsiodras, S., additional, Skoutelis, A., additional, Kourkouni, E., additional, Gkentzi, D., additional, Iosifidis, E., additional, Spyridis, N., additional, Kopsidas, I., additional, Karakosta, P., additional, Tsopela, G.C., additional, Spyridaki, I., additional, Kourlaba, G., additional, Coffin, S., additional, Zaoutis, E.T., additional, Papaevangelou, V., additional, Triantafyllidou, P., additional, Fanaraki, E., additional, Kaisari, K., additional, Kalabalikis, P., additional, Karachristou, K., additional, Katsibardi, K., additional, Kattamis, A., additional, Kazantzi, M., additional, Kitra, V., additional, Lourida, A., additional, Mpouza, E., additional, Papadopoulou, S., additional, Petrikkos, L., additional, Polychronopoulou, S., additional, Siahanidou, T., additional, Zannikos, K., additional, Giannopoulos, A., additional, Hatzipantelis, E., additional, Tragiannidis, A., additional, Goumperi, S., additional, Sdougka, M., additional, Lithoxopoulou, M., additional, Soubasi, V., additional, Baka, M., additional, Dimolitsa, C., additional, Doganis, D., additional, Kapetanakis, I., additional, Mavrogeorgos, G., additional, Nika, A., additional, Papachristidou, S., additional, Papadatos, I., additional, Tsintoni, A., additional, Baroutis, G., additional, Stratiki, E., additional, Skordala-Riti, M., additional, Tsouvala, E., additional, Gaitana, C., additional, Grivea, I., additional, Kaffe, A., additional, Giapros, V., additional, Gouvias, T., additional, Drougia, A., additional, Theodoraki, M., additional, Karavana, G., additional, Koropouli, M., additional, Thomou, C., additional, Kapetanaki, A., additional, Tzaki, M., additional, and Maistreli, S., additional

Published
2019
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6. Changing Epidemiology of Candida spp. Causing Bloodstream Infections in a Tertiary Hospital in Northern Greece: Appearance of Candida auris .

Author

Pyrpasopoulou A, Zarras C, Mouloudi E, Vakalis G, Ftergioti A, Kouroupis D, Papathanasiou AI, Iosifidis E, Goumperi S, Lampada C, Terzaki M, and Roilides E

Subjects
Humans, Retrospective Studies, Greece epidemiology, Child, Adult, Infant, Newborn, Infant, Child, Preschool, Drug Resistance, Fungal, Microbial Sensitivity Tests, Female, Male, Incidence, Cross Infection epidemiology, Cross Infection microbiology, SARS-CoV-2, Middle Aged, Tertiary Care Centers statistics & numerical data, Candidemia epidemiology, Candidemia microbiology, Candidemia drug therapy, Candidemia mortality, Antifungal Agents pharmacology, Antifungal Agents therapeutic use, COVID-19 epidemiology, Candida drug effects, Candida isolation & purification, Candida auris drug effects
Abstract

Introduction: The epidemiology of candidemia has shifted in the past few decades; drug-resistant non-albicans Candida species have become more prevalent worldwide. The aim of this retrospective study was to determine the epidemiology of Candida species isolated from hospitalized neonates, children and adults, and to investigate a potential changing susceptibility pattern in a large general tertiary hospital., Methods: All unique Candida strains isolated from candidemia cases between 1 January 2020 and 15 October 2024 were identified, and their susceptibility profile was characterized. The distribution pattern in different ward types (medical, surgical, pediatric and ICU) was recorded. Cumulative annual susceptibility profiles were compared., Results: Candidemia incidence increased during the COVID-19 pandemic, from 0.63/1000 patient-days in 2020 to 0.96/1000 patient-days in 2022, and has since slightly decreased (0.83 and 0.89 in 2023 and 2024, respectively). Candidemia-associated mortality was high (>50%) in 2020 and peaked during the pandemic. During the study period, Candida parapsilosis remained the most frequent Candida spp. However, since the first isolation of Candida auris from the bloodstream in late 2022, and despite intense infection control measures taken, its frequency sharply climbed to the second position after only C. parapsilosis in the first 10 months of 2024 (33.6% vs. 25.2% for C. parapsilosis and 21.0% for C. albicans ). While C. albicans has remained highly susceptible to fluconazole (1% resistance rate), C. parapsilosis manifested significant resistance to fluconazole during 2022-2024 (52%). C. auris was universally resistant to azoles and one isolate also resistant to echinocandins., Conclusions: A high prevalence of azole resistance of C. parapsilosis, the most frequently isolated Candida species, persists, and a significant rise of C. auris was recorded in nosocomial bloodstream infections with severe implications on public health.

Published
2025
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