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According to the document published by ANMCS – which shows a file of President Klaus Iohannis, at the press conference on Wednesday – between March and September 2020, 2,620 Adverse Events Associated with Medical Assistance (EAAAM) were reported. Of these, 1,356 resulted in a hospital infection (AMI)
Of these infections:
– 525 were in non-COVID hospitals (20.04%),
– 557 in support hospitals-COVID (21.26%),
– 274 in COVID hospitals (10.46%).
In 211 cases of these 1,356 hospital infections, it was an infection with the new coronavirus.
“Either a person was not infected and was infected in the hospital, or entered the hospital with suspicion, and the test was positive during hospitalization,” said Liana Subțirelu, spokesperson for ANMCS.
Key phrase in the press release accompanying the document:
“Health units with accredited beds or in the accreditation process report adverse events associated with health care (EAAAM) on a voluntary basis, without accusation, to the National Authority for Health Quality Management (ANMCS), (…) “
“The ANMCS voluntarily reports by mistake what hospitals consider important for the learning process. If a case is hypothetically considered trivial, we may not be informed,” Subirelu explained.
On the other hand, according to Order 1101/2016, all hospitals are obliged to report nosocomial infections to the Public Health Directorates, and these, then, in the centralized system of the National Institute of Public Health (INSP).
The INSP stated that “the Public Health Directorates have not reported (…) any case of infection associated with medical care in patients diagnosed with Covid-19”.
There is a national IAAM registry, but it is not mandatory
In the ANMCS report, the institution states that, in September, “the Registry of Health Associated Infections (R-IAAM) was implemented.”
“It is a tool developed by ANMCS to facilitate everyone’s work,” said Liana Subțirelu.
However, “ANMCS does not have access to the DSP reports. But the person in charge of DSP has access to our registry, ”the spokesperson also said.
At the moment, according to her, “there is no legal provision that all hospitals must enter the R-IAAM and I do not know that there is a unified informative discussion.”
In September, 86 hospitals reported 522 nosocomial infections in R-IAAM. Thus, more than a third of the total figure in the report (1,356) was entered in September alone, making the ANMCS figures unlikely to be the same as those reported for DSPs.
Between March and September 2020, 1,971,444 discharges of patients from continuous hospitalization were made in Romania. Of this total, the number of discharges of patients cured with COVID-19 was 92,647.
In 2017, in Romania, 19,607 hospital infections were reported according to data from the National Center for Public Health Statistics.
At the European level, according to the WHO, “it is estimated that around 80,000 hospitalized patients have at least one AMI on any given day. On average, AMI affects 7% of patients in developed countries and 15% of patients in low and middle developed countries. In developed countries, 30% of patients in intensive care units (ICU) have at least one of these AMI infections. In low and middle developed countries, the frequency of infection acquired in the ICU is at least 2-3 times higher than in developed countries ”.
In 2016, experts from the European Center for Communicable Disease Control (ECDC) wrote in a report on IAAM in Romania that “hospitals are a risky environment for vulnerable patients and not all nosocomial infections can be prevented. (…) Even in the best hospitals in the richest countries, patients can become infected due to the architecture of the hospital. It has always been and always will be, ”wrote the ECDC inspectors.
“However, when a very low infection rate is reported, we can suspect that it is an underreporting. Also, the high rates of reported infections can show that there is a problem, but at the same time they can show awareness, dedication of staff and a good information system, ”the report shows, according to Radio Free Europe Romania.
