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

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

Claudia Isonne  1 , Valentina Baccolini  1 , Giuseppe Migliara  1 , Mariateresa Ceparano  1 , Francesco Alessandri  2 , Giancarlo Ceccarelli  1 , Guglielmo Tellan  2 , Francesco Pugliese  2   3 , Maria De Giusti  1 , Corrado De Vito  1 , Carolina Marzuillo  1 , Paolo Villari  1 , Lavinia Camilla Barone  1 , Dara Giannini  1 , Daniela Marotta  1 , Mattia Marte  1 , Elena Mazzalai  1 , Irma Germani  2 , Arianna Bellini  1 , Andrea Bongiovanni  1 , Marta Castellani  1 , Ludovica D'Agostino  1 , Andrea De Giorgi  1 , Chiara De Marchi  1 , Elisa Mazzeo  1 , Shadi Orlandi  1 , Matteo Piattoli  2 , Eleonora Ricci  1 , Leonardo Maria Siena  1 , Alessandro Territo  1 , Stefano Zanni  1
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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

Claudia Isonne et al. J Clin Med. .

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.

Keywords: COVID-19; COVID-19 pandemic; SARS-CoV-2; devices-related infection; healthcare-associated infection; intensive care unit.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cumulative incidence of patients with at least one healthcare-associated infection (HAI) admitted to the Intensive Care Unit of Umberto I teaching hospital of Rome between 1 March 2020 and 6 June 2021 by study period.
Figure 2
Figure 2
Characteristics of healthcare-associated infections (HAIs) diagnosed in patients admitted to the Intensive Care Unit of Umberto I teaching hospital of Rome between 1 March 2020 and 6 June 2021 by study period. VAP, ventilation-associated pneumonia; CRBSI, catheter-related bloodstream infection; CAUTI, catheter-associated urinary tract infection; BUO, bloodstream infections of unknown origin; CDI, Clostridium difficile infection; SSI, surgical site infection.
Figure 3
Figure 3
Microorganisms responsible for healthcare-associated infections (HAIs) isolated in patients admitted to the Intensive Care Unit of Umberto I teaching hospital of Rome between 1 March 2020 and 6 June 2021.
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