Cent Eur J Public Health 2022, 30(3):196-200 | DOI: 10.21101/cejph.a7135

Healthcare-associated infections in COVID-19 ICU patients – two-centre study

Bartosz Kozłowski¹, Joanna Kubiak-Pulkowska², Julianna Pałka¹, Dominika Bożiłow¹, Magdalena Zając³, Aleksander Deptuła⁴

¹ Anaesthesiology and Intensive Care Unit, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland

² Jan Biziel University Hospital No. 2, Bydgoszcz, Poland

³ Faculty of Pedagogy, Kazimierz Wielki University, Bydgoszcz, Poland

⁴ Department of Propaedeutics of Medicine and Infection Prevention, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

Objective: The aim of this retrospective study was to estimate the prevalence of healthcare-associated infections (HAI), microbiological data including resistance patterns and impact of HAI on patients' survival.

Methods: Two-centre study on 172 patients was performed. Medical records of patients hospitalized in the two COVID-19 intensive care units (ICU) localized in Bydgoszcz between 1 October 2020 and 30 March 2021 were analysed retrospectively. Data collection included demographics, microbiological, clinical variables, and patient outcome. All infections were defined according to the HAI-Net ICU protocol of the European Centre for Disease Prevention and Control (ECDC). Detailed data concerning bloodstream infection (BSI), pneumonia (PN) and urinary tract infection (UTI) were collected.

Results: In 97 patients (56.4%), 138 HAI cases were identified. Patients with HAI statistically more often had been administered antimicrobial therapy prior to the admission to ICU (59.8% vs. 34.7%, p < 0.05), and needed catecholamines during hospitalization (93.8% vs. 70.7%, p < 0.001). The risk of HAI increased by 50% if antimicrobial therapy had been applied before the admission to ICU, and was three times higher if during the hospitalization in ICU catecholamines infusion was needed. Mortality was higher in patients diagnosed with HAI (72.2% vs. 65.3%) but the difference was not statistically significant (p = 0.34).

Conclusions: Further investigation of co-infections in critically ill patients with COVID-19 is required in order to identify HAI risk factors, define the role of empiric antimicrobial therapy and proper prevention strategies.

Keywords: healthcare-associated infections, intensive care unit, COVID-19, infection control

Received: September 29, 2021; Revised: September 21, 2022; Accepted: September 21, 2022; Published: September 30, 2022  Show citation