Four country healthcare-associated infection prevalence survey: pneumonia and lower respiratory tract infections

H. Humphreys*, R. G. Newcombe, J. Enstone, E. T.M. Smyth, G. McIlvenny, E. Davies, R. Spencer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


In 2006, the Hospital Infection Society was funded by the respective health services in England, Wales, Northern Ireland and the Republic of Ireland to conduct a prevalence survey of healthcare-associated infection (HCAI). Here, we report the prevalence of pneumonia and lower respiratory tract infection other than pneumonia (LRTIOP) in these four countries. The prevalence of all HCAIs was 7.59% (5743 out of 75 694). Nine hundred (15.7%) of these infections were pneumonia, and 402 (7.0%) were LRTIOP. The prevalence of both infections was higher for males than for females, and increased threefold from those aged <35 to those aged >85 years (P < 0.001). At the time of the survey or in the preceding seven days, 23.7% and 18.2% of patients with pneumonia and LRTIOP, respectively, were mechanically ventilated compared to 5.2% of patients in the whole study population. Meticillin-resistant Staphylococcus aureus (MRSA) was the cause of pneumonia and LRTIOP in 7.6% and 18.1% of patients, respectively (P < 0.001). More patients with LRTIOP (4.2%) had concurrent diarrhoea due to Clostridium difficile compared to patients with pneumonia (2.4%), but this did not reach statistical significance. Other HCAIs were present in 137 (15.2%) of patients with pneumonia and 66 (16.4%) of those with LRTIOP. The results suggest that reducing instrumentation, such as mechanical ventilation where possible, should help reduce infection. The higher prevalence of MRSA as a cause of LRTIOP suggests a lack of specificity in identifying the microbial cause and the association with C. difficile emphasises the need for better use of antibiotics.

Original languageEnglish
Pages (from-to)266-270
Number of pages5
JournalJournal of Hospital Infection
Issue number3
Publication statusPublished - Mar 2010
Externally publishedYes

Bibliographical note

Funding Information:
The study was funded by the respective health agencies of the participating countries, i.e. Department of Health, England, Welsh Healthcare Associated Infection Programme, the Department of Health, Social Services and Public Safety, Northern Ireland and The Health Service Executive, the Republic of Ireland.


  • Clostridium difficile
  • Healthcare-associated infection
  • Lower respiratory tract infection
  • Meticillin-resistant Staphylococcus aureus
  • Pneumonia


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