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

被引:15
作者
Lepape, Alain [1 ,2 ,3 ]
Machut, Anais [2 ,4 ]
Bretonniere, Cedric [2 ,5 ]
Friggeri, Arnaud [1 ,2 ,3 ]
Vacheron, Charles-Herve [1 ,2 ]
Savey, Anne [2 ,3 ,4 ]
机构
[1] Hosp Civils Lyon Groupement Sud, Serv Anesthesie Med Intens Med Perioperatoire & R, Lyon, France
[2] Hosp Civils Lyon Groupement Sud, REA REZO Surveillance Infect & Antibiot Resistanc, St Genis Laval, France
[3] Ctr Int Rech Infectiol Lyon, Publ Hlth Epidemiol & Evolutionary Ecol Infect Di, Lyon, France
[4] Hosp Civils Lyon, Hop Henry Gabrielle, CPias Auvergne Rhone Alpes, Lyon, France
[5] Nantes CHU, Inst Thorax, Unite Soins Intensifs Pneumol, Nantes, France
关键词
COVID-19; Hospital-acquired infections; Intensive care; Surveillance network; Ventilator-associated pneumonia; COVID-19; OUTCOMES;
D O I
10.1016/j.cmi.2022.10.023
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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], blood-stream 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. Alain Lepape, Clin Microbiol Infect 2023;29:530 (c) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:530 / 536
页数:7
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