The impact of healthcare-associated infections on mortality in ICU: A prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East.

Autor: Rosenthal VD; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Fl, USA; International Nosocomial Infection Control Consortium Foundation, Miami, Fl, USA. Electronic address: victor_rosenthal@inicc.org., Yin R; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Fl, USA., Lu Y; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Fl, USA., Rodrigues C; Pd Hinduja National Hospital And Medical Research Centre, Mumbai, India., Myatra SN; Tata Memorial Hospital, Homi Bhabha Nacional Institute, Mumbai, India., Kharbanda M; Desun Hospital, Kolkata, India., Valderrama-Beltran SL; Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia., Mehta Y; Medanta The Medicity, Haryana, India., Daboor MA; King Hussein Cancer Center, Amman, Jordan., Todi SK; Advanced Medicare Research Institute AMRI Hospitals, Kolkata, India., Aguirre-Avalos G; Hospital Civil de Guadalajara Fray Antonio Alcalde. Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico., Guclu E; Sakarya University Training and Research Hospital, Sakarya, Turkey., Gan CS; University Malaya Medical Centre, Kuala Lumpur, Malaysia., Jiménez-Alvarez LF; Clinica Universitaria Colombia, Bogota, Colombia., Chawla R; Indraprastha Apollo Hospitals, New Delhi, India., Hlinkova S; Catholic University In Ruzomberok, Faculty Of Health, Central Military Hospital Ruzomberok, Ruzomberok, Slovakia., Arjun R; Kerala Institute Of Med Sciences Health, Trivandrum, India., Agha HM; Cairo University Specialized Pediatric Hospital, Cairo, Egypt., Zuniga-Chavarria MA; Hospital Clinica Biblica, San Jose de Costa Rica, Costa Rica., Davaadagva N; Intermed Hospital, Ulaanbaatar, Mongolia., Basri MNM; International Islamic University Malaysia, Kuantan Pahang, Malaysia., Gomez-Nieto K; Clinica Sebastian de Belalcazar, Cali, Colombia., Aguilar-de-Moros D; Hospital del Niño Dr José Renán Esquivel, Panama, Panama., Tai CW; Universiti Kebangsaan Malaysia Specialist Children's Hospital, Kuala Lumpur, Malaysia., Sassoe-Gonzalez A; Hospital Regional de Alta Especialidad Ixtapaluca, Ixtapaluca, Mexico., Aguilar-Moreno LA; Clinica Infantil Santa María del Lago, Bogota, Colombia., Sandhu K; Max Super Speciality Hospital Saket Delhi, New Delhi, India., Janc J; Department of Anesthesiology and Intensive Therapy, 4th Clinical Military Hospital with Polyclinic, Wroclaw, Poland., Aleman-Bocanegra MC; Hospital San Jose TecSalud, Monterrey, Nuevo Leon, Mexico., Yildizdas D; Cukurova University. Balcali Hospital, Adana, Turkey., Cano-Medina YA; Instituto Del Corazon De Bucaramanga Sede Bogota, Bogota, Colombia., Villegas-Mota MI; Instituto Nacional de Perinatología, Mexico DF, Mexico., Omar AA; Infection Control Directorate. Ministry of Health, Kuwait City, Kuwait., Duszynska W; Wroclaw Medical University. Department of Anesthesiology and Intensive Therapy, Wroclaw, Poland., BelKebir S; An Najah National University Hospital, Nablus, Palestine., El-Kholy AA; Dar Alfouad Hospital, 6th of October City., 6th of October City, Egypt., Alkhawaja SA; Salmaniya Medical Center, Manama, Bahrain., Florin GH; University of Medicine and Pharmacy Victor Babes Timisoara Emergency Clinical County Hospital Romania, Timisoara, Romania., Medeiros EA; Hospital Sao Paulo, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Tao L; Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China., Memish ZA; King Saud Medical City, Riyadh, Kingdom of Saudi Arabia., Jin Z; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Fl, USA.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2023 Jun; Vol. 51 (6), pp. 675-682. Date of Electronic Publication: 2022 Sep 06.
DOI: 10.1016/j.ajic.2022.08.024
Abstrakt: Background: The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients.
Methods: Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries.
Results: Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P<.0001); ventilator-associated pneumonia (aOR:1.48; P<.0001); catheter-associated urinary tract infection (aOR:1.18;P<.0001); medical hospitalization (aOR:1.81; P<.0001); length of stay (LOS), risk rises 1% per day (aOR:1.01; P<.0001); female gender (aOR:1.09; P<.0001); age (aOR:1.012; P<.0001); central line-days, risk rises 2% per day (aOR:1.02; P<.0001); and mechanical ventilator (MV)-utilization ratio (aOR:10.46; P<.0001). Coronary ICU showed the lowest risk for mortality (aOR: 0.34;P<.0001).
Conclusion: Some identified risk factors are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; Central line-associated bloodstream infection, ventilator-associated pneumonia, catheter-associated urinary tract infection, LOS, and MV-utilization. So, to lower the risk of death in ICUs, we recommend focusing on strategies to shorten the LOS, reduce MV-utilization, and use evidence-based recommendations to prevent HAIs.
(Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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