Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;29(4):530-536.
doi: 10.1016/j.cmi.2022.10.023. Epub 2022 Oct 28.

Effect of SARS-CoV-2 infection and pandemic period on healthcare-associated infections acquired in intensive care units

Alain Lepape  1 , Anaïs Machut  2 , Cedric Bretonnière  3 , Arnaud Friggeri  4 , Charles-Hervé Vacheron  5 , Anne Savey  6 ; REA-REZO network
Affiliations

Effect of SARS-CoV-2 infection and pandemic period on healthcare-associated infections acquired in intensive care units

Alain Lepape et al. Clin Microbiol Infect. 2023 Apr.

Abstract

Objectives: To compare the occurrence of healthcare-associated infections acquired in intensive care units (HAI-ICUs) in France among patients with COVID-19 and those without it in 2020 and the latter with that in patients before the COVID-19 pandemic.

Methods: Multicentre HAI-ICU surveillance network (REA-REZO) data were used to identify 3 groups: 2019 patients (2019Control), a COVID-19 group (2020Cov), and a non-COVID-19 group (2020NonCov). The primary outcome was the occurrence of HAI-ICU (ventilator-associated pneumonia [VAP], bloodstream infections [BSIs], catheter-related bacteraemia). Standardized infection ratios of VAP were calculated for each quarter in 2020 and compared with those in 2019.

Results: A total of 30 105 patients were included in 2020: 23 798 in the 2020NonCov group, 4465 in 2020Cov group, and 39 635 patients in the 2019Control group. The frequency of VAP was strikingly greater in the 2020Cov group: 35.6 (33.4-37.8) episodes/1000 days of mechanical ventilation versus 18.4 (17.6-19.2) in the 2020NonCov group. VAP standardized infection ratio was high in 2020 patients, particularly during the 2 quarters corresponding to the 2 waves. BSI/1000 days were more frequent in the 2020Cov group (6.4% [6.4-6.4%] vs. 3.9% [3.8-3.9%] in the 2020NonCov group). VAP and BSI were also more frequent in the 2020NonCov group than in the 2019Control group. The microbial epidemiology was only slightly different.

Discussion: The data presented here indicate that HAI-ICUs were more frequent during the COVID-19 period, whether the patients were admitted for COVID-19 or, to a lesser extent, for another cause. This implies that managing patients with severe disease in a pandemic context carries risks for all patients.

Keywords: COVID-19; Hospital-acquired infections; Intensive care; Surveillance network; Ventilator-associated pneumonia.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart. 2020NonCov, non–COVID-19; 2020Cov, COVID-19 group.
See this image and copyright information in PMC

References

    1. Serafim R.B., Póvoa P., Souza-Dantas V., Kalil A.C., Salluh J.I.F. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review. Clin Microbiol Infect. 2021;27:47–54. doi: 10.1016/j.cmi.2020.10.017. - DOI - PMC - PubMed
    1. Aziz S., Arabi Y.M., Alhazzani W., Evans L., Citerio G., Fischkoff K., et al. Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med. 2020;46:1303–1325. doi: 10.1007/s00134-020-06092-5. - DOI - PMC - PubMed
    1. Lakbar I., Medam S., Ronflé R., Cassir N., Delamarre L., Hammad E., et al. Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia. Sci Rep. 2021;11 doi: 10.1038/s41598-021-95852-4. - DOI - PMC - PubMed
    1. Vacheron C.H., Lepape A., Savey A., Machut A., Timsit J.F., Vanhems P., et al. Increased incidence of ventilator-acquired pneumonia in coronavirus disease 2019 patients: a multicentric cohort study. Crit Care Med. 2022;50:449–459. doi: 10.1097/CCM.0000000000005297. - DOI - PMC - PubMed
    1. Vacheron C.H., Lepape A., Savey A., Machut A., Timsit J.F., Comparot S., et al. Attributable mortality of ventilator-associated pneumonia among patients with COVID-19. Am J Respir Crit Care Med. 2022;206:161–169. doi: 10.1164/rccm.202202-0357OC. - DOI - PMC - PubMed

MeSH terms