Healthcare-associated infections (HAI) are those contracted by hospitalized patients, and which are related to medical or surgical care. In Catalonia, HAIs are the main adverse event in hospitalized patients: they affect almost 7 out of every 100 admissions and are also the main generator of antibiotic resistance. For the patient who contracts the infection, who is often already in a compromised state of health, it has a considerable impact and can even increase their risk of death. In addition, HAIs place a significant economic burden on the public health system and worsen the quality of medical care. However, it is estimated that 35–55% of HAIs are preventable if proper protocols and practices are followed.
VINCat programme to reduce healthcare infections and the use of antimicrobials in Catalonia
It is to combat this problem that, in Catalonia, in 2006, the Catalan Health Service created the Programme for the Surveillance of Healthcare-Related Infections in Catalonia, the VINCat. With its progressive implementation in hospitals, social health centres (intermediate care) and primary care, this programme has made it possible to generate robust data, promote effective preventive interventions and significantly reduce the incidence of several HAIs, thus becoming a European benchmark in the surveillance and control of hospital infections and in the rational use of antimicrobials. As an example, in these two decades, 500,000 major surgery interventions have been monitored and preventive actions have been implemented, and around 3,000 cases of bacteraemia related to vascular catheters and urinary tract infections are monitored each year. In addition, in the fight against bacterial resistance, antibiotic consumption and antibiotic sensitivity are monitored in 63 hospitals, 87 social health centres and 43 CAPs in the country.
Overall, studies show that the Program has achieved significant milestones such as the reduction of infections in colorectal surgery by more than half (from 20% in 2011 to 6.7% in 2024) and the sustained decrease in infections associated with vascular catheters. In addition, infections associated with caesarean sections, a frequent surgery, have dropped by 30%. Another success of the program has been to significantly reduce the use of some antibiotics such as quinolones, a frequently used and broad-spectrum antibiotic. Hospitals have managed to reduce their administration by more than a third; more than half in the case of urinary tract infections in women, thus avoiding the generation of associated resistance. Key data has also been generated and other effective interventions have been promoted. All the results of these interventions have been published in scientific articles, carried out by research and health professionals from all over the country and led by Drs. Miquel Pujol and Enric Limón, current directors of the VINCat Program and principal investigators of IDIBELL.
To achieve these results, the ability of the VINCat to adapt to the evolution of the health system, with more healthcare complexity and an ageing population, has been key. The active participation of health centres that as members of the programme define their own objective performance indicators, surveillance in new areas such as social and health and primary care, the integration of rapid diagnostic techniques and the use of innovative technologies such as artificial intelligence, will allow the use of antibiotics to be optimised and point to a future with more precision in the detection and prevention of HAI.
Past, present and future of the VINCat Program
At the time, the conceptualization and launch of the Program were led by Dr. Francesc Gudiol, former head of the research group on Difficult-to-treat infections and use of antimicrobials at IDIBELL and Bellvitge Hospital, and Dr. Josep Maria Argimón, then director of the Catalan Health Service.
Now that the 20th anniversary of the Programme is approaching, the two directors agree that “the VINCat Programme has become an essential tool for the continuous improvement of the quality of care in Catalonia, demonstrating that the prevention of HAIs and the fight against antimicrobial resistance are possible with the commitment of the administration, quality research, teamwork by health professionals and raising awareness in society. They add that “Thanks to the efforts of many professionals, important progress has been made, although we are aware that there is still a lot of work to be done.
On 30 May, the 20th anniversary of the Programme will be celebrated with a commemorative day with the participation of relevant figures in public health such as Dr Marina Geli and Dr Josep Maria Argimon, former health ministers, and other directors and representatives. Present and future challenges in the fight against HAIs and antimicrobial resistance will be discussed.
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center established in 2004 specialized in cancer, neuroscience, translational medicine, and regenerative medicine. It counts on a team of more than 1.500 professionals who, from 73 research groups, publish more than 1.400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona, and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).