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卡塔尔西部一家重症监护病房中冠状病毒感染的十年发病率及其对医疗相关感染的发病率、病因和抗菌药物耐药性的影响。

Ten-year incidence and impact of coronavirus infections on incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar.

作者信息

Garcell Humberto Guanche, Al-Ajmi Jameela, Arias Ariadna Villanueva, Abraham Joji C, Garmendia Angel M Felipe, Hernandez Tania M Fernandez

机构信息

Infection Control Department, The Cuban Hospital. E-mail:

Corporate Infection Control Department, Hamad Medical Corporation, Qatar.

出版信息

Qatar Med J. 2023 Jul 28;2023(1):11. doi: 10.5339/qmj.2023.11. eCollection 2023.

Abstract

BACKGROUND

Healthcare-associated infections (HAI) in critical patients affect the quality and safety of patient care as they impact morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence rate was reported worldwide. We aim to describe the incidence of HAI in the intensive care unit (ICU) during a 10-year follow-up period and compare the incidence during the pre-COVID-19 and COVID-19 periods.

METHODS

A retrospective observational study of HAI in the medical-surgical ICU at The Cuban Hospital was conducted. The data collected include the annual incidence of HAI, its etiology, and antimicrobial resistance, using the Centers for Disease Control and Prevention definitions, except for other respiratory tract infections (RTIs).

RESULTS

A total of 155 patients had HAI, of which 130 (85.5%) were identified during COVID-19. The frequency of device-associated infections (DAI) and non-DAI was higher during COVID-19, except for infections. Etiology was frequently related to species of , , and in both periods, and a higher frequency of , , , , , and was noted during the COVID-19 period. Device utilization ratio increased by 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19, with a 2.79 higher risk of infection (95% CI: 0.93-11.21; < 0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08) for CLABSI, VAP, and CAUTI, respectively.

CONCLUSION

The incidence of DAI increased during the pandemic period as compared to the pre-pandemic period, and limited evidence of the impact on antimicrobial resistance was observed. The infection control program should evaluate strategies to minimize the impact of pandemics on HAI.

摘要

背景

重症患者的医疗相关感染(HAI)会影响患者护理的质量和安全,因为它们会影响发病率和死亡率。在新冠疫情期间,全球报告的发病率有所上升。我们旨在描述重症监护病房(ICU)在10年随访期内HAI的发病率,并比较新冠疫情前和疫情期间的发病率。

方法

对古巴医院内科-外科ICU的HAI进行了一项回顾性观察研究。收集的数据包括HAI的年发病率、病因及抗菌药物耐药性,采用美国疾病控制与预防中心的定义,但其他呼吸道感染(RTIs)除外。

结果

共有155例患者发生HAI,其中130例(85.5%)在新冠疫情期间被确诊。除感染外,新冠疫情期间与器械相关感染(DAI)和非DAI的发生率更高。两个时期的病因均常与、和的菌种有关,在新冠疫情期间观察到、、、、和的发生率更高。中心静脉导管的器械使用率增加了10.7%,呼吸机增加了12.9%,而导尿管使用率下降了15%。新冠疫情期间DAI的发病率更高,中心静脉导管相关血流感染(CLABSI)、呼吸机相关性肺炎(VAP)和导尿管相关尿路感染(CAUTI)的感染风险分别高2.79倍(95%CI:0.93-11.21;<0.0050)、15.31倍(2.53-625.48)和3.25倍(0.68-31.08)。

结论

与疫情前相比,疫情期间DAI的发病率有所增加,且观察到对抗菌药物耐药性影响的证据有限。感染控制计划应评估各种策略,以尽量减少疫情对HAI的影响。

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