重症监护病房中医疗保健相关感染的危险因素及其与COVID-19大流行浪潮的关系:一项巢式病例对照研究

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
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引用次数: 0

摘要

目的:评价2019冠状病毒病(COVID-19)大流行期间重症监护病房医护相关感染的危险因素,探讨COVID-19对中央静脉相关血流感染、导尿管相关尿路感染和呼吸机相关肺炎的影响,描述2019冠状病毒病大流行期间医护相关感染的情况。方法:该巢式病例对照研究于2019年1月11日至2022年5月21日在巴西圣保罗一家私立医院的137张床位的成人内科/外科重症监护病房进行。病例患者使用医院感染控制委员会数据库确定,对照患者使用重症监护病房的EPIMED系统确定。危险因素分析采用卡方检验、多元logistic回归模型和Kaplan-Meier方法确定独立危险因素,考虑到以下结果:病例组包括189例医疗保健相关感染,包括呼吸机相关肺炎(61.4%)、中央静脉相关血流感染(30.1%)、导尿管相关尿路感染(8.5%),对照组包括6834例患者。独立危险因素为COVID-19感染(OR=2.84, 95%CI=1.92 ~ 4.23)。结论:COVID-19和住院时间是医疗保健相关感染的独立危险因素,只有呼吸机相关性肺炎受COVID-19大流行的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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.

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Einstein-Sao Paulo
Einstein-Sao Paulo MEDICINE, GENERAL & INTERNAL-
CiteScore
2.00
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0.00%
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210
审稿时长
38 weeks
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