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Volume 2023, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Healthcare-associated infections (HAIs) in critical patients affect the quality and safety of patient care and increase patient morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence of HAIs, particularly device-associated infections (DAIs), was reported worldwide. In this study, we aimed to estimate the incidence of HAIs in an intensive care unit (ICU) during a 10-year period and compare HAI incidence during the preCOVID-19 and COVID-19 periods.Methods: A retrospective, observational study of HAIs in the medical–surgical ICU at The Cuban Hospital was conducted. DAIs included central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP). Data included the annual incidence of HAIs, etiology, and antimicrobial resistance, using definitions provided by the Centers for Disease Control and Prevention, except for other respiratory tract infections (RTIs).Results: 155 patients with HAI infections were reported, from which 130 (85.5%) were identified during the COVID-19 period. The frequencies of DAIs and non-DAIs were higher during the COVID-19 period, except for infections. Species under , , and dominated in both periods, and higher frequencies of , , , , , and were noted during COVID-19 period. Device utilization ratio increased to 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19 pandemic, with risks for CLABSI, VAP, and CAUTI increased by 2.79 (95% confidence interval, 0.93–11.21;  < 0.0050), 15.31 (2.53–625.48), and 3.25 (0.68–31.08), respectively.Conclusion: The incidence of DAIs increased during the pandemic period, with limited evidence of antimicrobial resistance observed. The infection control program should evaluate strategies to minimize the impact of the pandemic on HAIs.

© 2023 Garcell, Al-Ajmi, Arias, Abraham, Garmendia, Hernandez, licensee HBKU Press.
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2022-12-26
2024-04-19
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References

  1. Al-Tawfiq JA, Tambyah PA. Healthcare-associated infections (HAI) perspectives. J Infect Public Health. 2014 Jul-Aug; 7:(4):339–44. doi: 10.1016/j.jiph.2014.04.003.
     [Google Scholar]
  2. Joint Commission International Accreditation Standards for Hospitals, 7th Edition. Joint Commission Resources, 2020. ISBN (print): 978-1-63585-148-9.
  3. 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. 2021 Sep;3:1–14. doi: 10.1017/ice.2021.362.
     [Google Scholar]
  4. Ali HS, Khan FY, George S, Shaikh N, Al-Ajmi J, Epidemiology and outcome of ventilator-associated pneumonia in a heterogeneous ICU population in Qatar. Biomed Res Int. 2016;2016:8231787. doi: 10.1155/2016/8231787.
     [Google Scholar]
  5. Gupta P, Thomas M, Patel A, George R, Mathews L, Alex S, et al. Bundle approach used to achieve zero central line-associated bloodstream infections in an adult coronary intensive care unit. BMJ Open Qual. 2021 Feb; 10:(1):e001200. doi: 10.1136/bmjoq-2020-001200.
     [Google Scholar]
  6. Rosenthal VD, Myatra SN, Divatia JV, Biswas S, Shrivastava A, Ruzzieh MAA, et al. The impact of COVID-19 on healthcare-associated infections in intensive care units in low and middle-income countries: International Nosocomial Infection Control Consortium (INICC) findings. Int J Infect Dis. 2022 Feb 23:S1201-9712(22)00120-5. doi: 10.1016/j.ijid.2022.02.041.
     [Google Scholar]
  7. McMullen KM, Smith BA, Rebmann T, Impact of SARS-CoV-2 on hospital acquired infection rates in the United States: Predictions and early results. Am J Infect Control. 2020 Nov; 48:(11):1409–11. doi: 10.1016/j.ajic.2020.06.209.
     [Google Scholar]
  8. 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. 2021 Jun 4; 10:(1):87. doi: 10.1186/s13756-021-00959-y.
     [Google Scholar]
  9. Baker MA, Sands KE, Huang SS, Kleinman K, Septimus EJ, Varma N, et al. CDC Prevention Epicenters Program. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections. Clin Infect Dis. 2022; 74:(10):1748–54. doi: 10.1093/cid/ciab688.
     [Google Scholar]
  10. Fakih MG, Bufalino A, Sturm L, Huang RH, Ottenbacher A, Saake K, et al. Coronavirus disease 2019 (COVID-19) pandemic, central-line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): The urgent need to refocus on hardwiring prevention efforts. Infect Control Hosp Epidemiol. 2021 Feb 19:1–6. doi: 10.1017/ice.2021.70.
     [Google Scholar]
  11. Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, AzzamLopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis. 2021 Mar; 40:(3):495–502. doi: 10.1007/s10096-020-04142-w.
     [Google Scholar]
  12. 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. 2021 Jan; 27:(1):83–8. doi: 10.1016/j.cmi.2020.07.041.
     [Google Scholar]
  13. Baddley JW, Thompson GR 3rd, Chen SC, White PL, Johnson MD, Nguyen MH, et al. Coronavirus disease 2019-associated invasive fungal infection. Open Forum Infect Dis. 2021 Nov 16; 8:(12):ofab510. doi: 10.1093/ofid/ofab510.
     [Google Scholar]
  14. Intra J, Sarto C, Beck E, Tiberti N, Leoni V, Brambilla P, Bacterial and fungal colonization of the respiratory tract in COVID-19 patients should not be neglected. Am J Infect Control. 2020 Sep; 48:(9):1130–1. doi: 10.1016/j.ajic.2020.06.185.
     [Google Scholar]
  15. Gómez-Ochoa SA, Franco OH, Rojas LZ, Raguindin PF, Roa-Díaz ZM, Wyssmann BM, et al. COVID-19 in Health-Care Workers: A living systematic review and meta-analysis of prevalence, risk factors, clinical characteristics, and outcomes. Am J Epidemiol. 2021 Jan 4; 190:(1):161–75. doi: 10.1093/aje/kwaa191.
     [Google Scholar]
  16. Alajmi J, Jeremijenko AM, Abraham JC, Alishaq M, Concepcion EG, Butt AA, et al. COVID-19 infection among healthcare workers in a national healthcare system: The Qatar experience. Int J Infect Dis. 2020 Nov;100:386–9. doi: 10.1016/j.ijid.2020.09.027.
     [Google Scholar]
  17. Barman M, Tanweer H, Hatem A, Memom NI, Muhammad S, Harman TS, et al. Embracing healthcare delivery challenges during a pandemic. Review from a nodal designated COVID-19 center in Qatar. Avicenna. 2021;2:8. https://doi.org/10.5339/avi.2021.8.
     [Google Scholar]
  18. CDC/NHSN Surveillance Definitions for Specific Types of Infections, In: National Healthcare Safety Network (NHSN), USA. Patient Safety Component Manual. January 2021. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf. Accessed: December 18, 2021.
     [Google Scholar]
  19. Rosenthal VD, Duszynska W, Ider BE, Gurskis V, Al-Ruzzieh MA, Myatra SN, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2013-2018, Adult and Pediatric Units, Device-associated Module. Am J Infect Control. 2021 Oct; 49:(10):1267–74. doi: 10.1016/j.ajic.2021.04.077.
     [Google Scholar]
  20. Dudeck MA, Weiner LM, Allen-Bridson K, Malpiedi PJ, Peterson KD, Pollock DA, et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, Device-associated module. Am J Infect Control. 2013 Dec; 41:(12):1148–66. doi: 10.1016/j.ajic.2013.09.002.
     [Google Scholar]
  21. Dudeck MA, Edwards JR, Allen-Bridson K, Gross C, Malpiedi PJ, Peterson KD, et al. National healthcare safety network report, data summary for 2013, device-associated module. Am J Infect Control. 2015 Mar 1; 43:(3):206–21. doi: 10.1016/j.ajic.2014.11.014.
     [Google Scholar]
  22. Gaid E, Assiri A, McNabb S, Banjar W, Device-associated nosocomial infection in general hospitals, Kingdom of Saudi Arabia, 2013–2016. J Epidemiol Glob Health. 2018 Mar;7 Suppl 1(Suppl 1):S35–S40. doi: 10.1016/j.jegh.2017.10.008.
     [Google Scholar]
  23. Rebmann T, Alvino RT, Holdsworth JE, Availability and crisis standards of care for personal protective equipment during fall 2020 of the COVID-19 pandemic: A national study by the APIC COVID-19 task force. Am J Infect Control. 2021 Jun; 49:(6):657–62. doi: 10.1016/j.ajic.2021.03.015.
     [Google Scholar]
  24. Huang F, Armando M, Dufau S, Florea O, Brouqui P, Boudjema S, COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices. J HospInfect. 2021 May;111:27–34. doi: 10.1016/j.jhin.2021.03.004.
     [Google Scholar]
  25. Rouzé A, Martin-Loeches I, Povoa P, Makris D, Artigas A, Bouchereau M, et al. Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. Intensive Care Med. 2021 Feb; 47:(2):188–98. doi: 0.1007/s00134-020-06323-9.
     [Google Scholar]
  26. Rouzé A, Nseir S, Hospital-acquired pneumonia/ventilator-associated pneumonia and ventilator-associated tracheobronchitis in COVID-19. Semin Respir Crit Care Med. 2022 Apr; 43:(2):243-7. doi: 10.1055/s-0041-1740334.
     [Google Scholar]
  27. Rosenthal VD, Bat-Erdene I, Gupta D, Rajhans P, Myatra SN, Muralidharan S, et al. Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings. J Vasc Access. 2021 Jan; 22:(1):34–41. doi: 10.1177/1129729820917259.
     [Google Scholar]
  28. Guembe M, Pérez-Granda MJ, Capdevila JA, Barberán J, Pinilla B, Martín-Rabadán P, et al. Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments. J Hosp Infect. 2017 Nov; 97:(3):260–6. doi: 10.1016/j.jhin.2017.07.008.
     [Google Scholar]
  29. Lai CC, Chen SY, Ko WC, Hsueh PR, Increased antimicrobial resistance during the COVID-19 pandemic. Int J Antimicrob Agents. 2021 Apr; 57:(4):106324. doi: 10.1016/j.ijantimicag.2021.106324.
     [Google Scholar]
  30. Janniger EJ, Kapila R. Public health issues with Candida auris in COVID-19 patients. World Med Health Policy. 2021 Sep 16:10.1002/wmh3.472. doi: 10.1002/wmh3.472.
     [Google Scholar]
  31. Salah H, Sundararaju S, Dalil L, Salameh S, Al-Wali W, Tang P, et al. Genomic Epidemiology of Candida auris in Qatar Reveals Hospital Transmission Dynamics and a South Asian Origin. J Fungi (Basel). 2021 Mar 23; 7:(3):240. doi: 10.3390/jof7030240.
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2023.2
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Impact of the COVID-19 pandemic on the incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar
Qatar Medical Journal 2023, 2 (2023); https://doi.org/10.5339/qmj.2023.2
/content/journals/10.5339/qmj.2023.2
/content/journals/10.5339/qmj.2023.2
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  • Article Type: Research Article
Keyword(s): antimicrobial resistance, COVID-19, Device-associated infection, etiology, Healthcare-associated infections, incidence, intensive care unit and Qatar

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