Risk factors for hospital-acquired infection during the SARS-CoV-2 pandemic.

Autor: Kwon JH; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Nickel KB; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Reske KA; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Stwalley D; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Dubberke ER; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Lyons PG; Division of Pulmonary and Critical Care Medicine, Washington University in St Louis School of Medicine, St Louis, MO, USA., Michelson A; Division of Pulmonary and Critical Care Medicine, Washington University in St Louis School of Medicine, St Louis, MO, USA., McMullen K; Mercy, Infection Prevention, St Louis, MO, USA., Sahrmann JM; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Gandra S; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Olsen MA; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA., Burnham JP; Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, MO, USA. Electronic address: burnham@wustl.edu.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2023 Mar; Vol. 133, pp. 8-14. Date of Electronic Publication: 2022 Dec 06.
DOI: 10.1016/j.jhin.2022.11.020
Abstrakt: Objective: To evaluate risk factors for hospital-acquired infection (HAI) in patients during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, including historical and concurrent cohorts.
Design: Retrospective cohort.
Setting: Three Missouri hospitals, data from 1 st January 2017 to 30 th September 2020.
Participants: Patients aged ≥18 years and admitted for ≥48 h.
Methods: Univariate and multi-variate Cox proportional hazards models incorporating the competing risk of death were used to determine risk factors for HAI. A-priori sensitivity analyses were performed to assess the robustness of the urine-, blood- and respiratory-culture-based HAI definition.
Results: The cohort included 254,792 admissions, with 7147 (2.8%) HAIs (1661 blood, 3407 urine, 2626 respiratory). Patients with SARS-CoV-2 had increased risk of HAI (adjusted hazards ratio 1.65, 95% confidence interval 1.38-1.96), and SARS-CoV-2 infection was one of the strongest risk factors for development of HAI. Other risk factors for HAI included certain admitting services, chronic comorbidities, intensive care unit stay during index admission, extremes of body mass index, hospital, and selected medications. Factors associated with lower risk of HAI included year of admission (declined over the course of the study), admitting service and medications. Risk factors for HAI were similar in sensitivity analyses restricted to patients with diagnostic codes for pneumonia/upper respiratory infection and urinary tract infection.
Conclusions: SARS-CoV-2 was associated with significantly increased risk of HAI.
(Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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