危重病房COVID-19患者侵入性设备相关感染

IF 1.1 Q3 NURSING
F. Álvarez-Lerma MD, PhD, Equipo Directivo del Registro ENVIN, Grupo de Trabajo del Registro ENVIN
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引用次数: 0

摘要

入住重症监护病房的covid -19患者存在强烈的炎症反应,需要长时间更换器官或系统,这促进了感染并发症的出现。目的了解全国新型冠状病毒肺炎(COVID-19)患者有创器械相关感染(IRDI)及重症监护病房住院期间获得多重耐药菌(MBR)的情况。方法对国家多中心观察数据库(ENVIN-HELICS)中第一、第二和第四波大流行期间纳入的COVID-19患者进行回顾性分析。记录与机械通气相关的肺炎(N-MV)、与导尿管相关的尿路感染(UTI-SU)和与中心静脉导尿管相关的原发性菌血症(BP-CVC),发生率以发生率密度(ID)表示。记录重症监护病房住院期间获得的bmr,并以累积发生率(CI)表示。结果共纳入病例7778例,其中第一波1525例(19.6%),第二波3484例(44.8%),第四波2769例(35.6%)。第一、二波住院21天,第四波住院19.7天。第一波icu内死亡率,第二波从31%下降到26.3%,第四波下降到18.9%。每一波的N-MV率分别为每1000天14.31、13.56和19.99集。UTI-SU发生率分别为6.54、5.63和7.97 / 1000天。BP-CVC发生率分别为12.42、7.95和8.13 / 1000 CVC天。BMR率分别为每100例住院患者22.9、15.3和15.3。结论新冠肺炎患者的不同IRDI发生率在三波中均保持较高。在重症监护病房停留期间获得高BMR率,并在第四波中呈下降趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Infecciones relacionadas con dispositivos invasivos en pacientes COVID-19 ingresados en unidades de críticos

Introduction

COVID-19 patients admitted to critical care units present an intense inflammatory response and the need to replace organs or systems for long periods of time, which facilitates the presence of infectious complications.

Objectives

To present the national rates of infections related to invasive devices (IRDI) in COVID-19 patients, as well as the rates of multi-resistant bacteria (MBR) acquired during their stay in critical care units.

Method

Retrospective analysis of COVID-19 patients included during the first, second and fourth waves of the pandemic in a national observational and multicenter database (ENVIN-HELICS). Pneumonias related to mechanical ventilation (N-MV), urinary tract infections related to urethral catheter (UTI-SU) and primary bacteremia related to central venous catheters (BP-CVC) were recorded, whose rates are presented as incidence density (ID). The BMRs acquired during the stay in the critical care units were recorded and presented as cumulative incidence (CI).

Results

Seven thousand seven hundred seventy-eight patients were included, 1,525 (19.6%) in the first wave of the pandemic, 3,484 (44.8%) in the second, and 2,769 (35.6%) in the fourth. ICU stay of 21 days in the first and second waves and 19.7 days in the fourth. Intra-ICU mortality in the first wave, decreasing from 31% to 26.3% in the second and 18.9% in the fourth. N-MV rates of 14.31, 13.56, and 19.99 episodes per 1,000 days of MV in each wave. UTI-SU rates of 6.54, 5.63 and 7.97 episodes per 1000 days of SU. BP-CVC rates of 12.42, 7.95, and 8.13 per 1,000 CVC days. The BMR rate was 22.9, 15.3, and 15.3 BMR per 100 admitted patients.

Conclusions

High rates of the different IRDI in COVID patients that are maintained in the three waves analyzed. High rates of BMR acquired during the stay in critical care units with a tendency to decrease in the fourth wave.

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来源期刊
CiteScore
2.50
自引率
23.10%
发文量
48
期刊介绍: Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.
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