Anaesthesiology and Intensive Care Unit, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland.
Jan Biziel University Hospital No. 2, Bydgoszcz, Poland.
Cent Eur J Public Health. 2022 Sep;30(3):196-200. doi: 10.21101/cejph.a7135.
The aim of this retrospective study was to estimate the prevalence of healthcare-associated infections (HAI), microbiological data including resistance patterns and impact of HAI on patients' survival.
Two-centre study on 172 patients was performed. Medical records of patients hospitalized in the two COVID-19 intensive care units (ICU) localized in Bydgoszcz between 1 October 2020 and 30 March 2021 were analysed retrospectively. Data collection included demographics, microbiological, clinical variables, and patient outcome. All infections were defined according to the HAI-Net ICU protocol of the European Centre for Disease Prevention and Control (ECDC). Detailed data concerning bloodstream infection (BSI), pneumonia (PN) and urinary tract infection (UTI) were collected.
In 97 patients (56.4%), 138 HAI cases were identified. Patients with HAI statistically more often had been administered antimicrobial therapy prior to the admission to ICU (59.8% vs. 34.7%, p < 0.05), and needed catecholamines during hospitalization (93.8% vs. 70.7%, p < 0.001). The risk of HAI increased by 50% if antimicrobial therapy had been applied before the admission to ICU, and was three times higher if during the hospitalization in ICU catecholamines infusion was needed. Mortality was higher in patients diagnosed with HAI (72.2% vs. 65.3%) but the difference was not statistically significant (p = 0.34).
Further investigation of co-infections in critically ill patients with COVID-19 is required in order to identify HAI risk factors, define the role of empiric antimicrobial therapy and proper prevention strategies.
本回顾性研究旨在估计医疗保健相关感染（HAI）的患病率、包括耐药模式在内的微生物学数据，以及 HAI 对患者生存的影响。
对 172 例患者进行了两项中心研究。分析了 2020 年 10 月 1 日至 2021 年 3 月 30 日期间在比得哥什的两个 COVID-19 重症监护病房（ICU）住院的患者的病历。数据收集包括人口统计学、微生物学、临床变量和患者结局。所有感染均根据欧洲疾病预防控制中心（ECDC）的 HAI-Net ICU 方案进行定义。详细收集了血流感染（BSI）、肺炎（PN）和尿路感染（UTI）的数据。
在 97 例患者（56.4%）中，发现了 138 例 HAI 病例。与未发生 HAI 的患者相比，发生 HAI 的患者在入住 ICU 前更常接受抗菌治疗（59.8%比 34.7%，p < 0.05），且在住院期间更需要儿茶酚胺（93.8%比 70.7%，p < 0.001）。如果在入住 ICU 前使用了抗菌治疗，发生 HAI 的风险增加 50%，如果在 ICU 住院期间需要儿茶酚胺输注，则风险增加 3 倍。发生 HAI 的患者死亡率更高（72.2%比 65.3%），但差异无统计学意义（p = 0.34）。
需要进一步研究 COVID-19 重症患者的合并感染，以确定 HAI 的危险因素，确定经验性抗菌治疗和适当的预防策略的作用。
