CHEST Guidelines-Hospital-Acquired-Infections-in-Critically-Ill-Pat

Hospital-Acquired-Infections-in-Critically-Ill-Pat

Pdf Summary

The study titled "Hospital-Acquired Infections in Critically Ill Patients With COVID-19" conducted by Giacomo Grasselli and colleagues analyzes hospital-acquired infections (HAIs) among severely ill COVID-19 patients in Italian ICUs. The research involved a retrospective analysis of data from 774 patients admitted to eight Italian hospitals from February 20 to May 20, 2020. The study's key objective was to assess the incidence, microbial causes, resistance patterns of HAIs, and their impact on patient outcomes.<br /><br />The results indicated that nearly 46% of the patients developed 759 HAIs, with 35% caused by multidrug-resistant (MDR) bacteria. Ventilator-associated pneumonia (VAP) was the most common HAI, followed by bloodstream infections (BSIs) and catheter-related BSIs. The primary organisms involved were Gram-negative bacteria, including Enterobacterales, and Staphylococcus aureus.<br /><br />Key factors associated with HAIs included age, positive end expiratory pressure, and the use of broad-spectrum antibiotics upon admission. The study observed that HAIs significantly prolonged ICU and hospital stays, as well as the duration of mechanical ventilation. HAIs complicated by septic shock nearly doubled the mortality rate, although non-complicated infections did not significantly affect mortality.<br /><br />The study concludes that critically ill COVID-19 patients are highly susceptible to HAIs, particularly VAP and BSIs from MDR organisms. It emphasizes the importance of implementing surveillance and prevention protocols to reduce infectious complications, thereby potentially decreasing mortality and length of hospital stay among these patients.<br /><br />This research highlights the challenging environment of ICUs during the COVID-19 pandemic, accentuating the need for stringent infection control measures amidst the high-pressure context of severe COVID-19 care.

Keywords

COVID-19

hospital-acquired infections

critically ill patients

Italian ICUs

multidrug-resistant bacteria

ventilator-associated pneumonia

bloodstream infections

Gram-negative bacteria

infection control

mortality