Comparing the Occurrence of Healthcare-Associated Infections in Patients with and without COVID-19 Hospitalized during the Pandemic: A 16-Month Retrospective Cohort Study in a Hospital Intensive Care Unit

Isonne, Claudia; Baccolini, Valentina; Migliara, Giuseppe; Ceparano, Mariateresa; Alessandri, Francesco; Ceccarelli, Giancarlo; Tellan, Guglielmo; Pugliese, Francesco; Giusti, Maria De; Vito, Corrado De; Marzuillo, Carolina; Villari, Paolo; Barone, Lavinia; Giannini, Dara; Marotta, Daniela; Marte, Mattia; Mazzalai, Elena; Germani, Irma; Bellini, Arianna; Bongiovanni, Andrea; Castellani, Marta; D’Agostino, Ludovica; Giorgi, Andrea De; Marchi, Chiara; Mazzeo, Elisa; Orlandi, Shadi; Piattoli, Matteo; Ricci, Eleonora; Siena, Leonardo Maria; Territo, Alessandro; Zanni, Stefano

doi:10.3390/jcm11051446

Cited by 9 publications

(7 citation statements)

References 60 publications

(69 reference statements)

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“…Slovakia was hard hit by the COVID-19 epidemic mainly at the end of 2020 and in early 2021, when the number of new cases rapidly increased, and patients at risk of dying began to exceed the capacities of hospitals [19]. Based on our findings, CLABSI rates were consistent with the worsening COVID-19 epidemiological situation, and the same results were presented in other studies [25,30].…”

Section: Discussionsupporting

confidence: 88%

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic

Hlinkova,

Moraucikova,

Lesnakova

et al. 2023

Healthcare

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(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a high burden of COVID-19 infections, and hospitals faced greater challenges in preventing and managing CLABSI; (2) Methods: A retrospective analysis of CLABSI data from all patients admitted to adult respiratory intensive care units before and during COVID-19 pandemic was conducted. We followed the guidelines of the Center for Disease Control surveillance methodology for CLABSI. Data were analyzed using STATISTICA 13.1; (3) Results: We analyzed the data of 803 ICU patients hospitalized for 8385 bed days, with 7803 central line days. Forty-five CLABSI events were identified. The CLABSI rate significantly increased during the COVID-19 pandemic compared to before the COVID-19 pandemic (2.81 versus 7.47 events per 1000 central line days, (p < 0.001). The most frequently identified pathogens causing CLABSI were Gram-negative organisms (60.20%). The risk factors found to increase the probability of developing CLABSI were length of stay (OR = 1.080; 95% Cl: 1.057–1.103; p < 0.001) and COVID-19 (OR = 5.485; 95% Cl: 32.706–11.116; p < 0.001). (4) Conclusions: The COVID-19 pandemic was associated with increases in CLABSI in ICUs. These data underscore the need to increase efforts in providing surveillance of CLABSI and implementing infection prevention measures.

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Section: Discussionsupporting

confidence: 88%

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic

Hlinkova,

Moraucikova,

Lesnakova

et al. 2023

Healthcare

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“…In general, previous studies have indicated that COVID-19 patients are at increased risk, relative to non-COVID-19 patients, for hospital-onset MDRO HAIs. [22][23][24][25][26][27][28] Superinfection with MDRO S. aureus has been described in previous reports describing HAI incidence in COVID-19 patients. 8,14 Superinfection with MDRO S. aureus have been directly attributed to the management of COVID-19 patients, which often included used of catheters, intubation, and corticosteroid use.…”

Section: Discussionmentioning

confidence: 99%

Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infections in hospitalized patients

Farthing

Jolley

Nickel

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objective: We compared the individual-level risk of hospital-onset infections with multidrug-resistant organisms (MDROs) in hospitalized patients prior to and during the coronavirus disease 2019 (COVID-19) pandemic. We also quantified the effects of COVID-19 diagnoses and intrahospital COVID-19 burden on subsequent MDRO infection risk. Design: Multicenter, retrospective, cohort study. Setting: Patient admission and clinical data were collected from 4 hospitals in the St. Louis area. Patients: Data were collected for patients admitted between January 2017 and August 2020, discharged no later than September 2020, and hospitalized ≥48 hours. Methods: Mixed-effects logistic regression models were fit to the data to estimate patients’ individual-level risk of infection with MDRO pathogens of interest during hospitalization. Adjusted odds ratios were derived from regression models to quantify the effects of the COVID-19 period, COVID-19 diagnosis, and hospital-level COVID-19 burden on individual-level hospital-onset MDRO infection probabilities. Results: We calculated adjusted odds ratios for COVID-19–era hospital-onset Acinetobacter spp., P. aeruginosa and Enterobacteriaceae spp infections. Probabilities increased 2.64 (95% confidence interval [CI], 1.22–5.73) times, 1.44 (95% CI, 1.03–2.02) times, and 1.25 (95% CI, 1.00–1.58) times relative to the prepandemic period, respectively. COVID-19 patients were 4.18 (95% CI, 1.98–8.81) times more likely to acquire hospital-onset MDRO S. aureus infections. Conclusions: Our results support the growing body of evidence indicating that the COVID-19 pandemic has increased hospital-onset MDRO infections.

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“…Among the indirect consequences of the COVID-19 pandemic, an increase in the incidence of HAIs has been frequently reported, especially in some wards, such as ICUs [ 11 , 22 ]. However, most studies have focused on adult ICUs, while data on the impact of the pandemic on HAIs in NICUs are still scarce.…”

Section: Discussionmentioning

confidence: 99%

“…While the impact of the pandemic on incidence rates of nosocomial infections in adult ICUs has been investigated [ 6 , 11 , 12 , 13 ], data from the NICU setting are scarce. A few indirect effects of the pandemic on NICUs have been described, such as psychological distress or obstacles in implementing family-centered care [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study

Ceparano

Sciurti

Isonne

et al. 2023

JCM

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The COVID-19 pandemic may have had an impact on healthcare-associated infection (HAI) rates. In this study, we analyzed the occurrence of HAIs in a neonatal intensive care unit (NICU) of the Umberto I teaching hospital in Rome before and during the pandemic. All infants admitted from 1 March 2018 to 28 February 2022 were included and were divided into four groups according to their admission date: two groups before the pandemic (periods I and II) and two during the pandemic (periods III and IV). The association between risk factors and time-to-first event was analyzed using a multivariable Cox regression model. Over the four-year period, a total of 503 infants were included, and 36 infections were recorded. After adjusting for mechanical ventilation, birth weight, sex, type of delivery, respiratory distress syndrome, and previous use of netilmicin and fluconazole, the multivariable analysis confirmed that being hospitalized during the pandemic periods (III and IV) was the main risk factor for HAI acquisition. Furthermore, a change in the etiology of these infections was observed across the study periods. Together, these findings suggest that patient management during the pandemic was suboptimal and that HAI surveillance protocols should be implemented in the NICU setting promptly.

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Comparing the Occurrence of Healthcare-Associated Infections in Patients with and without COVID-19 Hospitalized during the Pandemic: A 16-Month Retrospective Cohort Study in a Hospital Intensive Care Unit

Cited by 9 publications

References 60 publications

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic

Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infections in hospitalized patients

Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study

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