site.btaPatients with Hospital-Acquired Infections in Bulgaria Half the European Average, But Data Not Reported Correctly, Doctors Warn

Antibiotic policy should be improved and strict control should be exercised over the use of antibiotics, urge doctors participating in a national campaign to reduce healthcare-associated infections (HAIs). The initiative, organized organized by the Bulgarian Association of Healthcare Professionals and the ONE Health Bulgarian Association, aims to raise awareness about HAIs among healthcare professionals in Bulgaria.

The Bulgarian Association of Healthcare Professionals quotes data on the spread of HAIs in Europe provided by a 2022-2023 prevalence study of the European Centre for Disease Prevention and Control. The data for Bulgaria were obtained from 3,997 monitored hospitalizations in 23 second- and third-level hospitals. According to the data, there were 147 patients with confirmed HAIs, or 4%, compared to the European average of 8%. Among the cases monitored, 22% of all infections occurred before the patient's admission (as opposed to 26% in Europe), and 76% during their hospitalization (as opposed to 71% in Europe). Infections of unknown origin accounted for 29% in Bulgaria, compared to under 3% in Europe, the data show. This discrepancy in much of the data in Bulgaria and Europe leads to the conclusion that HAIs are not being reported correctly in Bulgaria, which limits the ability of specialists to identify the problem and work to eliminate it.

In addition to this campaign, other activities aimed at raising awareness and changing attitudes are planned, as Bulgaria is one of the leaders in antimicrobial resistance, Dr. Dragomir Ivanov, Chairman of ONE Health Bulgarian Association and coordinator of the European Commission's EU-JAMRAI 2 initiative, told reporters on Monday.

Prof. Emma Keuleyan, head of the microbiology, virology, and hospital hygiene laboratory at Lozenets University Hospital in Sofia and coordinator of the EU-JAMRAI 2 initiative at the Ministry of Health, said that the widespread use of antibiotics is in outpatient care, and the main recommendation is for general practitioners to prescribe antibiotics only in cases of proven infection, but this means that these doctors must be provided with greater diagnostic capabilities, she added. According to her, intensive care units are hot spots for the emergence of resistance because that is where antibiotics are used in the largest quantities.

A draft regulation on control of HAIs, which is to be put to public discussion, provides for special microbiological tests to be carried out on risk group (patients with diabetes, those aged over 65, and patients with several health issues) when they are admitted to hospital. The aim is to determine whether a patient is a carrier of risk strains. According to the rules, if multidrug-resistant microorganisms are found, the patient should be isolated in a separate hospital room and cared for by dedicated staff. This would lead to two problems: the need for more funds for microbiological laboratories and a lack of sufficient single rooms in hospitals. This must become a priority in Bulgaria to protect people's health, added Prof. Keuleyan.