Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort

被引：0

作者：

Tomazini, Bruno Martins ^{[1
,2
,3
]}

Besen, Bruno Adler Maccagnan Pinheiro ^{[2
,3
,4
]}

Santos, Renato Hideo Nakagawa ^{[1
]}

Nassar Jr, Antonio Paulo ^{[3
,5
,6
]}

Veiga, Thabata Silva ^{[1
]}

Campos, Viviane Bezerra ^{[1
]}

Tokunaga, Samira Martins ^{[1
]}

Santos, Elton Sousa ^{[1
]}

Barbante, Leticia Galvao ^{[1
]}

da Costa Maia, Renato ^{[1
]}

Kojima, Flavia Cristina Soares ^{[1
]}

Laranjeira, Ligia Nasi ^{[1
]}

Taniguchi, Leandro Utino ^{[3
,4
]}

Roepke, Roberta Muriel Longo ^{[3
,7
]}

Franke, Cristiano Augusto ^{[8
]}

Sanches, Luciana Coelho ^{[9
]}

Melro, Livia Maria Garcia ^{[10
,11
]}

Maia, Israel Silva ^{[3
,12
]}

de Souza Dantas, Vicente Ces ^{[13
]}

Figueiredo, Rodrigo Cruvinel ^{[14
]}

de Alencar Filho, Meton Soares ^{[15
]}

Irineu, Vivian Menezes ^{[16
]}

Lovato, Wilson Jose ^{[17
]}

Zandonai, Cassio Luis ^{[18
]}

Machado, Flavia Ribeiro ^{[3
,10
]}

Arns, Beatriz ^{[19
]}

Marsola, Giovanna ^{[20
]}

Veiga, Viviane Cordeiro ^{[3
,21
]}

Pereira, Adriano Jose ^{[3
,5
]}

Cavalcanti, Alexandre Biasi ^{[1
,3
]}

机构：

[1] Hosp Coracao, HCor Res Inst, Rua Desembargador Eliseu Guilherme 200,8th Floor, BR-04004030 Sao Paulo, SP, Brazil

[2] Hosp Sirio Libanes, Diretoria Compromisso Social, Sao Paulo, SP, Brazil

[3] Brazilian Res Intens Care Network BRICNet, Sao Paulo, Brazil

[4] Univ Sao Paulo, Hosp Clin HCFMUSP, Intens Care & Emergency Med, Fac Med, Sao Paulo, Brazil

[5] Hosp Israelita Albert Einstein, Sao Paulo, SP, Brazil

[6] AC Camargo Canc Ctr, Sao Paulo, SP, Brazil

[7] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Trauma & Acute Care Surg Intens Care Unit, Sao Paulo, SP, Brazil

[8] Hosp Pronto Socorro Porto Alegre, Porto Alegre, RS, Brazil

[9] Hosp Amor, Barretos, SP, Brazil

[10] Univ Fed Sao Paulo UNIFESP, Hosp Sao Paulo, Sao Paulo, SP, Brazil

[11] Hosp Samaritano, Sao Paulo, SP, Brazil

[12] Hosp Inst Baia Sul, Florianopolis, SC, Brazil

[13] Hosp Naval Marcilio Dias, Rio De Janeiro, RJ, Brazil

[14] Hosp Maternidade Sao Jose, Colatina, MG, Brazil

[15] Hosp Maternidade Sao Vicente Paulo, Barbalha, CE, Brazil

[16] Hosp Leo Orsi, Itapetininga, SP, Brazil

[17] Univ Sao Paulo, Hosp Clin Ribeirao Preto, Fac Med, Ribeirao Preto, SP, Brazil

[18] Hosp Nereu Ramos, Florianopolis, SC, Brazil

[19] Hosp Moinhos Vento, Porto Alegre, RS, Brazil

[20] Hosp Alemao Oswaldo Cruz, Sao Paulo, SP, Brazil

[21] BP Beneficencia Portuguesa Sao Paulo, Sao Paulo, SP, Brazil

来源：

CRITICAL CARE | 2025年 / 29卷 / 01期

关键词：

Healthcare associated infection; Intensive care unit; Ventilator-associated pneumonia; Bloodstream infection; Attributable mortality; VENTILATOR-ASSOCIATED PNEUMONIA; ATTRIBUTABLE MORTALITY;

D O I：

10.1186/s13054-024-05203-8

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BackgroundLimited data is available to evaluate the burden of device associated healthcare infections (HAI) [central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP)] in low and-middle-income countries. Our aim is to investigate the population attributable mortality fraction and the absolute mortality difference of HAI in a broad population of critically ill patients from Brazil.MethodsMulticenter cohort study from September 2019 to December 2023 with prospective individual patient data collection. VAP, CLABSI, and CAUTI were diagnosed by each center in accordance with Brazilian regulatory agency guidance. If a patient fulfilled all diagnostic criteria, he was deemed to have Confirmed HAI. An adjusted disability multistate model was used to evaluate the population attributable in-hospital mortality fraction (PAF) and the absolute in-hospital mortality difference (AMD).ResultsA total of 128,247 patients were included. 4066 (3.2%) distinct patients had at least one diagnosis of HAI (1493 CLABSI, 433 CAUTI, 2742 VAP, and 435 patients with more than one HAI) during the ICU stay. The PAF was 3.89% (95% CI 3.68-4.11%) for HAI, 2.16% (2.05-2.33%) for VAP, 1.2% (1.08-1.32%) for CLABSI, 0.11% (0.07-0.16%) for CAUTI, and 0.33% (0.26-0.4%) for >= 2 HAI. The AMD for HAI was 33.69% (95% CI 32.27-35.33%), 29.01% (27.15-30.98%) for VAP, 31.64% (29.3-34.81%) for CLABSI, 9.94% (3.88-15.54%) for CAUTI and 35.6% (28.93-42.99%) for >= 2 HAI.ConclusionsDevice-associated HAI significantly contribute to hospital mortality and impose a high excess risk of death for critically ill patients.

引用

页数：9

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