Healthcare-associated infections related to COVID-19 in intensive care unit patients
DOI:
https://doi.org/10.26694/repis.v9i1.4437Palabras clave:
COVID-19, Cross Infection, Intensive Care UnitsResumen
Introduction: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has precipitated a global health crisis, potentially amplifying healthcare-associated infections (HAIs). Aim: To observe the impact of HAIs on COVID-19 patients admitted to the ICU of a hospital in Southern Maranhão. Design: This study is descriptive, retrospective, and quantitative, based on primary data from hospital records spanning June to November 2020. Results: The study encompassed 274 patients, with an average age of 63 years (range: 18-97 years). A low incidence of HAIs in COVID-19 patients in the ICU (2.91%) was observed during the study period. The utilization rate of invasive devices was 33.21%, with CVD (97.8%) being the predominant type. CVD-associated urinary tract infection (UTI) caused by Candida sp. accounted for 50% of diagnosed HAIs. The mortality rate attributable to HAIs in COVID-19 patients in the ICU is 1.46%, whereas the rate among those without HAIs is 25.91%. Implications: The study reveals a limited impact of HAIs on the clinical outcomes of COVID 19 patients admitted to the ICU, suggesting the need to promoting complete COVID-19 vaccination.
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Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med [Internet]. 2020 [cited 2022 Jun 19];382(8):727–33. Available from: https://doi.org/10.1056/NEJMoa2001017
Moura EC, Silva EN, Sanchez MN, Cavalcante FV, Oliveira LG, Oliveira A, et al. Timely availability of public data for health management: COVID-19 wave´s analysis. SciELO Preprints [Internet]. 2021 [cited 2022 Jun 19]. Available from: https://doi.org/10.1590/SciELOPreprints.2316
Brasil. Ministério da Saúde. Coronavírus Brasil: Painel COVID-19 [Internet]. 2022 [accessed 2022 May 16]. Available from: https://covid.saude.gov.br/
Instituto Brasileiro de Geografia e Estatística (IBGE). Índice de desenvolvimento humano 2010 [Internet]. [cited 2022 May 16]. Available from: https://cidades.ibge.gov.br/brasil/ma/pesquisa/37/30255
Scheffer M, Cassenote A, Guerra A, Miotto R, Brandão A, Gomes J, et al. Demografia Médica no Brasil 2020. São Paulo: FMUSP, CFM; 2020. [accessed 2022 May 16]. Available from: https://cdn-flip3d.sflip.com.br/temp_site/issue-7ffb4e0ece07869880d51662a2234143.pdf
Brasil. Ministério da Saúde. Gabinete do Ministro. Portaria nº 1.514, de 15 junho de 2020. Diário Oficial da União. 2020 Jun 16; [cited 2022 Jun 19]. Available from: https://www.in.gov.br/web/dou/-/portaria-n-1.514-de-15-de-junho-de-2020-261697736
Santos-Pinto CDB, Miranda ES, Osorio-de-Castro CGS. O “kit-covid” e o Programa Farmácia Popular do Brasil. Cad Saúde Pública [Internet]. 2021 [cited 2022 Jun 19];37(2):e00348020. Available from: https://doi.org/10.1590/0102-311X00348020
Ruiz J. Enhanced antibiotic resistance as a collateral COVID-19 pandemic effect? J Hosp Infect [Internet]. 2021 Jan [cited 2022 Jun 19];107:114-15. Available from: https://doi.org/10.1016/j.jhin.2020.11.010
Silva LOP, Emanuele AA, Joseli MRN. Consequências do uso indiscriminado de antimicrobianos durante a pandemia de COVID-19. Brazilian J Develop [Internet]. 2022 Feb [cited 2022 Jun 19];8(2):10381-97. Available from: https://doi.org/10.34117/bjdv8n2-128
Barrasa H, Martín A, Maynar J, Rello J, Fernández-Torres M, Aguirre-Quiñonero A, et al. High rate of infections during ICU admission of patients with severe SARS-CoV-2 pneumonia: A matter of time? J Infect [Internet]. 2021 May [cited 2022 Jun 19];82(5):186-230. Epub 2020 Dec 5. Available from: https://doi.org/10.1016/j.jinf.2020.12.001
Stevens MP, Patel PK, Nori P. Involving antimicrobial stewardship programs in COVID-19 response efforts: all hands on deck. Infect Control Hosp Epidemiol [Internet]. 2020 [cited 2022 Jun 19];41:744–745. Available from: https://doi.org/10.1017/ice.2020.69
Costa RL, Lamas C, Simvoulidis L, Espanha C, Moreira L, Bonancim R, et al. Secondary infections in a cohort of patients with COVID-19 admitted to an intensive care unit: impact of gram-negative bacterial resistance. Rev Inst Med trop S Paulo [Internet]. 2022 Feb [cited 2022 Jun 19];64. Available from: https://doi.org/10.1590/S1678-9946202264006
Ribas RM, Campos PA, Brito CS, Gontijo-Filho PP. Coronavirus Disease 2019 (COVID-19) and healthcare-associated infections: Emerging and future challenges for public health in Brazil. Travel Med Infect Dis [Internet]. 2020 Sep-Oct [cited 2022 Jun 19];37:101675. Epub 2020 Apr 17. Available from: https://doi.org/10.1016/j.tmaid.2020.101675
Palmore TN, Henderson DK. Healthcare-associated infections during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol [Internet]. 2021 Nov [cited 2022 Jun 19];42(11):1372-1373. Epub 2021 Sep 2. Available from: https://doi.org/10.1017/ice.2021.377
Cioffi A, Rinaldi R. COVID-19 and healthcare-associated infections. Int J Risk Saf Med [Internet]. 2020 [cited 2022 Jun 19];31(4):181-182. Available from: https://doi.org/10.3233/jrs-200056
Barroso BIL, Souza MBCA, Bregalda MM, Lancman S, Da Costa VBB. A saúde do trabalhador em tempos de COVID-19: reflexões sobre saúde, segurança e terapia ocupacional. Cad Bras Ter Ocup [Internet]. 2020 [cited 2022 Jun 19];28(3):1093-102. Available from: https://doi.org/10.4322/2526-8910.ctoARF2091
Paul E, Ibrahim A, Alzaydani A, Al-Hakami A, Harish CC, Alshehri S, et al. Healthcare workers’ perspectives on healthcare-associated infections and infection control practices: a video-reflexive ethnography study in the Asir region of Saudi Arabia. Antimicrob Resist Infect Control [Internet]. 2020 [cited 2022 Jun 19];9(110):1-12. Available from: https://doi.org/10.1186/s13756-020-00756-z
Agência Nacional de Vigilância Sanitária (Anvisa). Programa nacional de prevenção e controle de infecções relacionadas à assistência à saúde (PNPCIRAS) 2021 a 2025. Brasília: Ministério da Saúde; 2021 [cited 2022 Jun 19]. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/pnpciras_2021_2025.pdf
Khazaei S, Ayubi E, Jenabi E, Bashirian S, Shojaeian M, Tapak L. Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran. Epidemiol Health [Internet]. 2020 Jun [cited 2022 Jun 19];42. Available from: https://doi.org/10.4178/epih.e2020037
Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis [Internet]. 2008 Apr [cited 2022 Jun 19];197(8):1079-81. Available from: https://doi.org/10.1086/533452
Asmarawati TP, Rosyid AN, Suryantoro SD, Mahdi BA, Windradi C, Wulaningrum PA, et al. The clinical impact of bacterial co-infection among moderate, severe, and critically ill COVID-19 patients in the second referral hospital in Surabaya. F1000Research [Internet]. 2021 Feb [cited 2022 Jun 19];10:113. Available from: https://doi.org/10.12688/f1000research.31645.2
Ferreira GRON, Tyll MAG, Viana PF, Silva VKBR. Perfil epidemiológico das infecções relacionada a assistência à saúde em unidade de terapia intensiva adulto em hospital referência materno-infantil do Pará. Rev Epidemiol Control Infect [Internet]. 2019 Oct [cited 2022 Jun 19];9(4). Available from: https://doi.org/10.17058/.v9i4.12482
Agência Nacional de Vigilância Sanitária (Anvisa). Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de Antimicrobianos em Serviços de Saúde. Brasília: Ministério da Saúde; 2017 [cited 2022 Jun 19]. Available from: http://antigo.anvisa.gov.br/documents/33852/271855/Diretriz+Nacional+para+Elabora%C3%A7%C3%A3o+de+Programa+de+Gerenciamento+do+Uso+de+Antimicrobianos+em+Servi%C3%A7os+de+Sa%C3%BAde/667979c2-7edc-411b-a7e0-49a6448880d4?version=1.0
Kumar G, Adams A, Hererra M, Rojas ER, Singh V, Sakhuja A, et al. Predictors and outcomes of healthcare-associated infections in COVID-19 patients. Int J Infect Dis [Internet]. 2021 Mar [cited 2022 Jun 19];104:287-292. Available from: https://doi.org/10.1016/j.ijid.2020.11.135
Grasselli G, Scaravilli V, Mangioni D, Scudeller L, Alagna L, Bartoletti M, et al. Hospital-Acquired Infections in Critically Ill Patients With COVID-19. Chest [Internet]. 2021 Aug [cited 2022 Jun 19];160(2):454-65. Epub 2021 Apr 20. Available from: https://doi.org/10.1016/j.chest.2021.04.002
Baccolini V, Migliara G, Isonne C, Dorelli B, Barone LC, Giannini D, et al. The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study. Antimicrob Resist Infect Control [Internet]. 2021 Jun [cited 2022 Jun 19];10(1):87. Available from: https://doi.org/10.1186/s13756-021-00959-y
Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect [Internet]. 2020 Aug [cited 2022 Jun 19];81(2):266-275. Epub 2020 May 27. Available from: https://doi.org/10.1016/j.jinf.2020.05.046
Russell CD, Fairfield CJ, Drake TM, Turtle L, Seaton RA, Wootton DG, et al. Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study. Lancet Microbe [Internet]. 2021 Aug [cited 2022 Jun 19];2(8):e354-65. Epub 2021 Jun 2. Available from: https://dx.doi.org/10.1016/S2666-5247(21)00090-2
Soriano MC, Vaquero C, Ortiz-Fernandez A, Caballero A, Blandino-Ortiz A, Pablo R. Low incidence of co-infection, but high incidence of ICU-acquired infections in critically ill patients with COVID-19. J Infect [Internet]. 2021 Feb [cited 2022 Jun 19];82(2):e20–e21. Available from: https://doi.org/10.1016/j.jinf.2020.09.010
Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect [Internet]. 2021 [cited 2022 Jun 19];27(1):83-88. Available from: https://doi.org/10.1016/j.cmi.2020.07.041
Khurana S, Singh P, Sharad N, Kiro VV, Rastogi N, Lathwal A, et al. Profile of co-infections & secondary infections in COVID-19 patients at a dedicated COVID-19 facility of a tertiary care Indian hospital: Implication on antimicrobial resistance. Indian J Med Microbiol [Internet]. 2021 Apr [cited 2022 Jun 19];39(2):147-153. Available from: https://doi.org/10.1016/j.ijmmb.2020.10.014
Chen S, Zhu Q, Xiao Y, Wu C, Jiang Z, Liu L, Qu J. Clinical and etiological analysis of co-infections and secondary infections in COVID-19 patients: An observational study. Clin Respir J [Internet]. 2021 Jul [cited 2022 Jun 19];15(7):815-825. Epub 2021 Apr 19. Available from: https://doi.org/10.1111/crj.13369
Weiner-Lastinger LM, Pattabiraman V, Konnor RY, Patel PR, Wong E, Xu SY, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol [Internet]. 2022 Jan [cited 2022 Jun 19];43(1):12-25. Epub 2021 Sep 3. Erratum in: Infect Control Hosp Epidemiol [Internet]. 2022 Jan [cited 2022 Jun 19];43(1):137. Available from: https://doi.org/10.1017/ice.2021.362
Baker MA, Sands KE, Huang SS, Kleinman K, Septimus EJ, Varma N, et al. The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections. Clin Infect Dis [Internet]. 2022 May [cited 2022 Jun 19];74(10):1748-54. Available from: https://doi.org/10.1093/cid/ciab688
Lu DE, Hung SH, Su YS, Lee WS. Analysis of Fungal and Bacterial Co-Infections in Mortality Cases among Hospitalized Patients with COVID-19 in Taipei, Taiwan. J Fungi (Basel) [Internet]. 2022 Jan [cited 2022 Jun 19];8(1):91. Available from: https://doi.org/10.3390/jof8010091
Chiurlo M, Mastrangelo A, Ripa M, Scarpellini P. Invasive fungal infections in patients with COVID-19: a review on pathogenesis, epidemiology, clinical features, treatment, and outcomes. New Microbiol [Internet]. 2021 Apr [cited 2022 Jun 19];44(2):71-83. PMID: 34240742.
Porto APM, Borges IC, Buss L, Machado A, Bassetti BR, Cocentino B, et al. Healthcare-associated infections on the intensive care unit in 21 Brazilian hospitals during the early months of the coronavirus disease 2019 (COVID-19) pandemic: An ecological study. Infect Control Hosp Epidemiol [Internet]. 2022 Mar [cited 2022 Jun 19];18:1-37. Available from: https://doi.org/10.1017/ice.2022.65
Ripa M, Galli L, Poli A, Oltolini C, Spagnuolo V, Mastrangelo A, et al. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect [Internet]. 2021 Mar [cited 2022 Jun 19];27(3):451-457. Epub 2020 Oct 24. Available from: https://doi.org/10.1016/j.cmi.2020.10.021
Rawson TM, Moore LSP, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing. Clin Infect Dis [Internet]. 2020 Dec [cited 2022 Jun 19];71(9):2459-2468. Available from: https://doi.org/10.1093/cid/ciaa530
Riche CVW, Cassol R, Pasqualotto AC. Is the Frequency of Candidemia Increasing in COVID-19 Patients Receiving Corticosteroids? J Fungi (Basel) [Internet]. 2020 Nov [cited 2022 Jun 19];6(4):286. Available from: https://doi.org/10.3390/jof6040286
