Risk factors for healthcare-associated infections and their relationship with waves of the COVID-19 pandemic in an intensive care unit: a nested case-control study.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Einstein-Sao Paulo Pub Date : 2024-12-16 eCollection Date: 2024-01-01 DOI:10.31744/einstein_journal/2024AO0939
Fernando Gatti de Menezes, Thiago Domingos Corrêa, Bruno de Arruda Bravim, Paula Tuma, Moacyr Silva Júnior, Emy Akiyama Gouveia, Alexandra do Rosário Toniolo, Graziela Geanfrancisco Matta de Paiva, Paula Fernanda Martineli, Helena Maria Fernandes Castagna, Talita Silva Sarro Moraes, Ana Carolina Santiago, Priscila Gonçalves, Brunna Oliveira Pereira, Nathalia Thomazi Gonçalves, Daniel Tavares Malheiro, Vanessa Damazio Teich, Miguel Cendoroglo Neto
{"title":"Risk factors for healthcare-associated infections and their relationship with waves of the COVID-19 pandemic in an intensive care unit: a nested case-control study.","authors":"Fernando Gatti de Menezes, Thiago Domingos Corrêa, Bruno de Arruda Bravim, Paula Tuma, Moacyr Silva Júnior, Emy Akiyama Gouveia, Alexandra do Rosário Toniolo, Graziela Geanfrancisco Matta de Paiva, Paula Fernanda Martineli, Helena Maria Fernandes Castagna, Talita Silva Sarro Moraes, Ana Carolina Santiago, Priscila Gonçalves, Brunna Oliveira Pereira, Nathalia Thomazi Gonçalves, Daniel Tavares Malheiro, Vanessa Damazio Teich, Miguel Cendoroglo Neto","doi":"10.31744/einstein_journal/2024AO0939","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk factors for healthcare-related infections during the COVID-19 pandemic in intensive care units, to investigate the impact of COVID-19 on Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and ventilator-associated pneumonia, and to describe healthcare-associated infections in the waves of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This nested case-control study was conducted in a 137-bed adult medical/surgical intensive care unit at a private hospital in São Paulo, Brazil, between January 11, 2019, and May 21, 2022. Case patients were identified using the Nosocomial Infection Control Committee database and control patients were identified using the intensive care unit's EPIMED system. For the analysis of risk factors, the chi-square test, multiple logistic regression model, and Kaplan-Meier method were used to identify independent risk factors, considering p<0.05.</p><p><strong>Results: </strong>The Case Group consisted of 189 healthcare-associated infections, including ventilator-associated pneumonia (61.4%), Central Line-Associated Bloodstream Infection (30.1%), Catheter-Associated Urinary Tract Infection (8.5%), and the Control Group consisted of 6,834 patients. The independent risk factors were COVID-19 infection (OR=2.84, 95%CI=1.92-4.23, p<0.01), length of stay in intensive care greater than 14 days (OR=3.15, 95%CI=1.95-5.14, p<0.01), length of hospital stay greater than 30 days (OR=3.64, 95%CI=2.44-5.51, p<0.01), and patients who were in the third wave (OR=1.72, 95%CI=1.05-2.91, p=0.04). Ventilator-associated pneumonia was the only healthcare-related infection for which COVID-19 infection was an independent risk factor (OR=3.32, 95%CI=1.92-5.94, p<0.01).</p><p><strong>Conclusion: </strong>COVID-19 and length of hospital stay were independent risk factors for healthcare-associated infections, and only ventilator-associated pneumonia was affected by the COVID-19 pandemic.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"22 ","pages":"eAO0939"},"PeriodicalIF":1.1000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Einstein-Sao Paulo","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31744/einstein_journal/2024AO0939","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To evaluate the risk factors for healthcare-related infections during the COVID-19 pandemic in intensive care units, to investigate the impact of COVID-19 on Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and ventilator-associated pneumonia, and to describe healthcare-associated infections in the waves of the COVID-19 pandemic.

Methods: This nested case-control study was conducted in a 137-bed adult medical/surgical intensive care unit at a private hospital in São Paulo, Brazil, between January 11, 2019, and May 21, 2022. Case patients were identified using the Nosocomial Infection Control Committee database and control patients were identified using the intensive care unit's EPIMED system. For the analysis of risk factors, the chi-square test, multiple logistic regression model, and Kaplan-Meier method were used to identify independent risk factors, considering p<0.05.

Results: The Case Group consisted of 189 healthcare-associated infections, including ventilator-associated pneumonia (61.4%), Central Line-Associated Bloodstream Infection (30.1%), Catheter-Associated Urinary Tract Infection (8.5%), and the Control Group consisted of 6,834 patients. The independent risk factors were COVID-19 infection (OR=2.84, 95%CI=1.92-4.23, p<0.01), length of stay in intensive care greater than 14 days (OR=3.15, 95%CI=1.95-5.14, p<0.01), length of hospital stay greater than 30 days (OR=3.64, 95%CI=2.44-5.51, p<0.01), and patients who were in the third wave (OR=1.72, 95%CI=1.05-2.91, p=0.04). Ventilator-associated pneumonia was the only healthcare-related infection for which COVID-19 infection was an independent risk factor (OR=3.32, 95%CI=1.92-5.94, p<0.01).

Conclusion: COVID-19 and length of hospital stay were independent risk factors for healthcare-associated infections, and only ventilator-associated pneumonia was affected by the COVID-19 pandemic.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Einstein-Sao Paulo
Einstein-Sao Paulo MEDICINE, GENERAL & INTERNAL-
CiteScore
2.00
自引率
0.00%
发文量
210
审稿时长
38 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信