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比较大流行期间住院的新冠肺炎患者与非新冠肺炎患者医院感染的发生率:一项在医院重症监护病房进行的为期16个月的回顾性队列研究。

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.

作者信息

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

机构信息

Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.

Department of Anaesthesia and Intensive Care Medicine, Umberto I Teaching Hospital, Sapienza University of Rome, 00161 Rome, Italy.

出版信息

J Clin Med. 2022 Mar 7;11(5):1446. doi: 10.3390/jcm11051446.

Abstract

The COVID-19 pandemic has increased the healthcare-associated infection (HAI) risk in intensive care unit (ICU) patients. However, a comparison between patients with and without COVID-19 in terms of HAI incidence has been rarely explored. In this study, we characterized the occurrence of HAI among patients with and without COVID-19 admitted to the ICU of the Umberto I hospital of Rome during the first 16 months of the pandemic and also identified risk factors for HAI acquisition. Patients were divided into four groups according to their ICU admission date. A multivariable conditional risk set regression model for multiple events was constructed for each admission period. Adjusted hazard ratios and 95% confidence intervals were calculated. Overall, 352 COVID-19 and 130 non-COVID-19 patients were included, and a total of 361 HAIs were recorded. We found small differences between patients with and without COVID-19 in the occurrence and type of HAI, but the infections in the two cohorts mostly involved different microorganisms. The results indicate that patient management was likely an important factor influencing the HAI occurrence during the pandemic. Effective prevention and control strategies to reduce HAI rates should be implemented.

摘要

新型冠状病毒肺炎(COVID-19)大流行增加了重症监护病房(ICU)患者发生医疗保健相关感染(HAI)的风险。然而,很少有人探讨感染COVID-19的患者与未感染COVID-19的患者在HAI发生率方面的差异。在本研究中,我们描述了在大流行的前16个月期间,罗马翁贝托一世医院ICU收治的感染和未感染COVID-19的患者中HAI的发生情况,并确定了获得HAI的危险因素。根据患者入住ICU的日期将其分为四组。为每个入住时间段构建了一个针对多个事件的多变量条件风险集回归模型。计算调整后的风险比和95%置信区间。总体而言,纳入了352例COVID-19患者和130例非COVID-19患者,共记录了361例HAI。我们发现感染和未感染COVID-19的患者在HAI的发生和类型方面存在细微差异,但两个队列中的感染大多涉及不同的微生物。结果表明,患者管理可能是影响大流行期间HAI发生的一个重要因素。应实施有效的预防和控制策略以降低HAI发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d7/8910983/4eb25d2a72d8/jcm-11-01446-g001.jpg

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