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COVID-19 患者中与医疗保健相关的感染的患病率和死亡率:回顾性队列社区方法。

Prevalence and mortality rate of healthcare-associated infections among COVID-19 patients: a retrospective cohort community-based approach.

机构信息

Department of Infectious Diseases, Saint-Georges Hospital, Hadat, Lebanon.

Department of Nursing, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.

出版信息

Front Public Health. 2023 Aug 10;11:1235636. doi: 10.3389/fpubh.2023.1235636. eCollection 2023.

Abstract

BACKGROUND

The prevalence of HAI among COVID-19 patients ranged between 4.8% and 42.8% with the highest occurrence observed in critically ill patients. The present study aimed to evaluate the clinical features of HAI in severe and critical COVID-19 patients, their microbiological characteristics, and the attributable risk factors.

METHODS

This is an analytical observational, retrospective single-center, cohort study that included 723 patients with severe-critical COVID-19 admitted to Saint George Hospital between September 2020 and February 2021. Data collection included demographic variables (sex, age), comorbidities, laboratory findings, HAI types and agents, COVID-19 treatment modalities, hospitalization settings, length of stay, and mortality rate. Data was analyzed using SPSS version 25.

RESULTS

The prevalence of patients developing HAI was 7.3% (53 of 723). Five types of nosocomial bacterial infections were tracked noting ventilator-associated pneumonia (41.26%), catheter-associated urinary tract infection (28.6%), hospital-acquired pneumonia (17.44%), catheter-related bloodstream infection (6.35%), and bloodstream infection (6.35%). Binary logistic analysis showed that HAI are statistically affected by four factors noting patients' age ( = 0.039), Length of Stay ( < 0.001), BIPAP ( = 0.019), and mechanical ventilation ( < 0.001). The risk of having HAI increases 3.930 times in case of mechanical ventilation, 2.366 times in case of BIPAP, 1.148 times when the LOS increases 1 day, and 1.029 times when the age is higher with 1 year.

CONCLUSION

Since the prevalence of HAI is high among severe and critical COVID-19 patients, it is important to prepare a treatment with diagnostic, preventative, and control measures for this infection.

摘要

背景

COVID-19 患者中 HAI 的患病率在 4.8%至 42.8%之间,危重症患者中发生率最高。本研究旨在评估严重和危重新冠肺炎患者 HAI 的临床特征、微生物学特征和归因风险因素。

方法

这是一项分析性观察性、回顾性单中心队列研究,纳入 2020 年 9 月至 2021 年 2 月期间圣乔治医院收治的 723 例严重-危重新冠肺炎患者。数据收集包括人口统计学变量(性别、年龄)、合并症、实验室检查结果、HAI 类型和病原体、COVID-19 治疗方式、住院环境、住院时间和死亡率。数据使用 SPSS 25 版进行分析。

结果

发生 HAI 的患者患病率为 7.3%(53/723)。共追踪到 5 种医院获得性细菌感染类型,分别为呼吸机相关性肺炎(41.26%)、导管相关性尿路感染(28.6%)、医院获得性肺炎(17.44%)、导管相关血流感染(6.35%)和血流感染(6.35%)。二元逻辑分析表明,HAI 受 4 个因素的统计学影响,即患者年龄( = 0.039)、住院时间( < 0.001)、BIPAP( = 0.019)和机械通气( < 0.001)。发生 HAI 的风险在机械通气时增加 3.930 倍,在 BIPAP 时增加 2.366 倍,在 LOS 增加 1 天时增加 1.148 倍,在年龄增加 1 岁时增加 1.029 倍。

结论

由于严重和危重新冠肺炎患者中 HAI 的患病率较高,因此重要的是要为这种感染制定诊断、预防和控制措施的治疗方案。

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