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. 2021 Jun 4;10(1):87.
doi: 10.1186/s13756-021-00959-y.

The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study

V Baccolini #  1 , G Migliara #  2 , C Isonne  2 , B Dorelli  2 , L C Barone  2 , D Giannini  2 , D Marotta  2 , M Marte  2 , E Mazzalai  2 , F Alessandri  3 , F Pugliese  3   4 , G Ceccarelli  2 , C De Vito  2 , C Marzuillo  2 , M De Giusti  2 , P Villari  2
Affiliations

The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study

V Baccolini et al. Antimicrob Resist Infect Control. .

Abstract

Background: During the intensive care units' (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients.

Methods: Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey's regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort.

Results: Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31-5.38, and SHR: 10.0, 95% CI 1.84-54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections.

Conclusions: We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.

Keywords: COVID-19; Devices-related infections; Healthcare-associated infection; Intensive care unit; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cumulative incidence function for first healthcare-associated infection (a) or first device-related healthcare-associated infection (b) among the patients admitted to the main Intensive Care Unit (ICU) of Umberto I teaching hospital of Rome between 1st March and 4th April 2019 and 1st March and 4th April 2020
Fig. 2
Fig. 2
Cumulative incidence function for first healthcare-associated infection (a) or first device-related healthcare-associated infection (b) among the patients admitted to the main intensive care unit of Umberto I teaching hospital of Rome between 1st March and 4th April 2020
See this image and copyright information in PMC

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MeSH terms