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Ismael YH, Pacheco E Castilho HG, Zhen F, Yamaguto GE, Moriya VL, Maestri AC, Kussen GMB, Nogueira MB, Petterle R, Shimidt ALA, Moreira FN, da Silva Nogueira K, Raboni SM. Clinical and microbiological profile of health care-associated infections in a tertiary hospital: Comparison between a cohort of hospitalized patients during prepandemic and COVID-19 pandemic periods. Am J Infect Control 2024; 52:712-718. [PMID: 38181901 DOI: 10.1016/j.ajic.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, health service practices underwent significant changes, impacting the occurrence of health care-associated infections (HAIs). This study presents the epidemiology of bacterial infections and compares clinical data on nosocomial infections in hospitalized patients before and during the pandemic. METHODS A unicentric, observational, retrospective cohort study was conducted with descriptive analyses on the microorganism identification and resistance profile. Patient's clinical data who had hospital-acquired infection (HAI), during their hospitalization in a tertiary hospital before and during the COVID-19 pandemic was compared by descriptive and inferential analyses. RESULTS A total of 1,581 bacteria were isolated from 1,183 hospitalized patients. Among patients coinfected with COVID-19, there was a statistically significant increase in HAI-related deaths (P < .001) and HAI caused by multidrug-resistant organisms (P < .001), mainly by Acinetobacter baumannii and Staphylococcus aureus. A higher odds ratio of HAI-related deaths compared to the prepandemic period was observed (odds ratio 6.98 [95% confidence interval 3.97-12.64]). CONCLUSIONS The higher incidence of multidrug-resistant bacteria and increased deaths due to HAI, especially in patients with COVID-19 coinfection, might be related to various factors such as increased workload, broad-spectrum antibiotic use, and limited resources. The pandemic has changed the profile of circulating bacteria and antimicrobial resistance. Prevention strategies should be considered to reduce the impact of these infections.
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Affiliation(s)
- Youssef H Ismael
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Felipe Zhen
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Guilherme E Yamaguto
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Vitor L Moriya
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Adriane C Maestri
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Gislene M B Kussen
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Meri B Nogueira
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ricardo Petterle
- Department of Integrative Medicine, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ana L A Shimidt
- Hospital Infection Control Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Fabíola N Moreira
- Hospital Infection Control Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Keite da Silva Nogueira
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Sonia M Raboni
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
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Safarabadi M, Motallebirad T, Azadi D, Jadidi A. Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic. J Intensive Care Med 2024:8850666241249162. [PMID: 38711296 DOI: 10.1177/08850666241249162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The current review article provides a comprehensive analysis of nosocomial infections in pediatric and adult intensive care units (ICUs) in Iran. We examine the risk factors and etiology of nosocomial infections, with a particular focus on molecular epidemiology and antimicrobial sensitivity. In this article, we explore a range of prevention strategies, including hand hygiene, personal protective equipment, environmental cleaning, antibiotic stewardship, education, and training. Moreover, we discuss the impact of the COVID-19 pandemic on infection control measures in ICUs and provide valuable insights for healthcare professionals and policymakers seeking to address this critical public health issue. In conclusion, this review article can serve as a valuable resource for those interested in understanding and improving infection control in ICUs and beyond.
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Affiliation(s)
- Mehdi Safarabadi
- Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran
| | - Tahereh Motallebirad
- Department of Research and Development, Satras Biotechnology Company, Islamic Azad University of Khomein, Khomein, Iran
| | - Davood Azadi
- Department of Research and Development, Satras Biotechnology Company, Islamic Azad University of Khomein, Khomein, Iran
- Department of Biology, Faculty of Basic Sciences, Lorestan University, Khorramabad, Iran
| | - Ali Jadidi
- Department of Traditional Medicine, School of Medicine, Arak University Of medical Sciences, Arak, Iran
- School of Nursing, Arak University of Medical Sciences, Arak, Iran
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Bayani M, Rouhi S, Mohammadi Abandansari R, Jafarian F, Ahmadnia Z, Ghorbani H, Firouzjahi A, Ranaee M, Ahmadi Goorji S. The nosocomial infection survey among patients suffering from the Coronavirus disease-2019 hospitalized in Ayatollah Rouhani Hospital, Babol. CASPIAN JOURNAL OF INTERNAL MEDICINE 2024; 15:509-518. [PMID: 39011447 PMCID: PMC11246687 DOI: 10.22088/cjim.15.3.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/26/2023] [Accepted: 12/11/2023] [Indexed: 07/17/2024]
Abstract
Background Having a weakened immune system can make patients easily get nosocomial infection (NI) with multi-drug resistant (MDR) bacteria and put them in a dangerous situation. It causes long hospital stays, disability, economic burden, and even death. The present study aimed to determine the prevalence of NI in patients suffering from COVID-19. Methods In this retrospective study, the information on 250 patients suffering from COVID-19 in the intensive care unit (ICU) (2020 to 2021) was considered. For statistical analysis, analysis of variance (ANOVA), paired samples t-test, and chi-square using SPSS-23 software were used (p<0.05). Results Two hundred and fifty hospitalized (107 females and 143 males, mean ± standard deviation (SD) of age; 56.50 ± 17.20) patients were considered. The most (97.60%) medicine prescribed was remdesivir. Candida spp. (two females), Escherichia coli (two females), Acinetobacter spp. (one female), Citrobacter spp. (one female), Pseudomonas spp. (one male), Sphingomonas spp. (one male), Stenotrophomonas spp. (one male) and Enterobacter spp. (one male) were isolated from the patient's specimens. Four of seven bacterial isolates were positive for MDR. NI was diagnosed in six patients. There was no significant relationship between the age with the isolated microbes (P=0.154) and MDR (P=0.987) and also between gender with common microbes (P=0.576) and MDR (P=0.143). Conclusion The coexistence of bacteria and NI was observed in patients. Remdesivir was prescribed for most patients. Most bacteria were resistant to antibiotics, especially, β-lactams.
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Affiliation(s)
- Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Samaneh Rouhi
- Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | | | - Farzane Jafarian
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Ahmadnia
- Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Ghorbani
- Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Alireza Firouzjahi
- Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ranaee
- Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Somayeh Ahmadi Goorji
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ismaeil R, Nahas ARF, Kamarudin NB, Abubakar U, Mat-Nor MB, Mohamed MHN. Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia. BMC Infect Dis 2023; 23:779. [PMID: 37946158 PMCID: PMC10636815 DOI: 10.1186/s12879-023-08770-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. METHOD This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients' electronic medical records. RESULTS There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. CONCLUSION Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
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Affiliation(s)
- Rehab Ismaeil
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Abdul Rahman Fata Nahas
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Norhidayah Binti Kamarudin
- Department of Medical Microbiology, Kulliyyah of Medicine, International Islamic University Malaysia, 25200, Kuantan, Malaysia
| | - Usman Abubakar
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, 2713, Doha, Qatar.
| | - Mohamad Basri Mat-Nor
- Department of Intensive Care, Kulliyyah of Medicine, International Islamic University Malaysia, 25200, Kuantan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia.
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Abubakar U, Awaisu A, Khan AH, Alam K. Impact of COVID-19 Pandemic on Healthcare-Associated Infections: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2023; 12:1600. [PMID: 37998802 PMCID: PMC10668951 DOI: 10.3390/antibiotics12111600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023] Open
Abstract
This study investigated how the Coronavirus Disease 2019 (COVID-19) pandemic has affected the rate of healthcare-associated infections (HAIs). PubMed, Scopus and Google Scholar were searched to identify potentially eligible studies published from December 2019 to September 2022. A random effect model was used to determine the changes in the rate of HAIs during the pandemic. Thirty-seven studies, mostly from the United States (n = 13), were included. Fifteen studies described how the pandemic affected the rate of CLABSIs and CAUTIs, and eight of them showed a significant increase in CLABSIs. The risk of CLABSIs and CDIs was 27% (pooled odds ratio [OR]: 0.73; confidence interval [CI]: 0.61-0.89; p < 0.001) and 20% (pooled OR: 1.20; CI: 1.10-1.31; p < 0.001) higher during the pandemic compared to before the COVID-19 pandemic period, respectively. However, the overall risk of HAIs was unaffected by the pandemic (pooled OR: 1.00; 95 CI: 0.80-1.24; p = 0.990). Furthermore, there were no significant changes in the risk of CAUTIs (pooled OR: 1.01; 95 CI: 0.88-1.16; p = 0.890), and SSIs (pooled OR: 1.27; CI: 0.91-1.76; p = 0.16) between the two periods. The COVID-19 pandemic had no effect on the overall risk of HAIs among hospitalized patients, but an increased risk of CLABSIs and CDI were observed during the pandemic. Therefore, more stringent infection control and prevention measures and prudent interventions to promote the rational use of antibiotics are warranted across all healthcare facilities to reduce the burden of HAIs.
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Affiliation(s)
- Usman Abubakar
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Malaysia
| | - Khurshid Alam
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Malaysia
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Barchitta M, Maugeri A, Favara G, Lio RMS, La Rosa MC, D'Ancona F, Agodi A. The intertwining of healthcare-associated infections and COVID-19 in Italian intensive care units: an analysis of the SPIN-UTI project from 2006 to 2021. J Hosp Infect 2023; 140:124-131. [PMID: 37562591 DOI: 10.1016/j.jhin.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/02/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Although healthcare-associated infections (HAIs) pose an extraordinary burden on public health, the impact of coronavirus disease 2019 (COVID-19) is still a matter of debate. AIM To describe trends of HAIs in Italian intensive care units (ICUs) from 2006 to 2021, and to compare characteristics and outcomes of patients with or without COVID-19. METHODS We evaluated patients participating in the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' (SPIN-UTI) project, who were admitted to ICUs for more than 48 h. Data regarding diagnosis, clinical conditions, therapies, treatments and outcomes of COVID-19 patients were also collected. FINDINGS From a total of 21,523 patients from 2006 to 2021, 3485 (16.2%) presented at least one HAI. We observed an increasing trend for both the incidence of patients with HAI and the incidence density of HAIs (P-trend <0.001). Compared with the pre-pandemic period, the incidence density of HAIs increased by about 15% in 2020-2021, with pneumoniae being the greatest contributors to this increase (P-trend <0.001). Moreover, incidence of HAIs was higher in ICUs dedicated to COVID-19 patients (P<0.001), who showed a greater risk of HAIs and death than patients without COVID-19 (P-values <0.001). Accordingly, the mortality in ICUs increased over the years and doubled during the pandemic (P-trend <0.001). Notably, co-infected patients had higher mortality (75.2%) than those with COVID-19 (66.2%) or HAI (39.9%) alone, and those without any infection (23.2%). CONCLUSIONS Our analysis provides useful insight into whether and how the COVID-19 pandemic influenced HAI incidence and death in Italian ICUs, highlighting the need for evaluation of the long-term effects of the pandemic.
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Affiliation(s)
- M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - A Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - G Favara
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - M C La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - F D'Ancona
- GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Istituto Superiore di Sanità, Rome, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico - San Marco', Catania, Italy.
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Oy S, Saing CH, Ung M, Zahari M, Nouhak I, Kim S, Nagashima-Hayashi M, Khuon D, Koy V, Mam S, Sayasone S, Saphonn V, Yi S. Developing an infection prevention and control intervention to reduce hospital-acquired infections in Cambodia and Lao People's Democratic Republic: the HAI-PC study protocol. Front Public Health 2023; 11:1239228. [PMID: 37799162 PMCID: PMC10548876 DOI: 10.3389/fpubh.2023.1239228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023] Open
Abstract
Background Hospital-acquired infections (HAIs) are significant public health issues, especially in low-and middle-income countries (LMICs). Hand hygiene and low-level disinfection of equipment practices among healthcare workers are some of the essential measures to reduce HAIs. Various infection prevention and control (IPC) interventions to reduce HAI incidence have been developed. However, effective interventions have not been well developed in the LMICs context. Therefore, this protocol aims to develop, pilot, and assess the feasibility and acceptability of an IPC intervention in Cambodia and the Lao People's Democratic Republic. Methods This study will consist of four phases guided by the Medical Research Council (MRC) Framework. Three hospitals will be purposely selected - each from the district, provincial, and national levels - in each country. The gap analysis will be conducted in Phase 1 to explore IPC practices among healthcare workers at each hospital through desk reviews, direct observation of hand hygiene and low-level disinfection of equipment practices, in-depth interviews with healthcare workers, and key informant interviews with stakeholders. In Phase 2, an IPC intervention will be developed based on the results of Phase 1 and interventions selected from a systematic literature review of IPC interventions in LMICs. In Phase 3, the developed intervention will be piloted in the hospitals chosen in Phase 1. In Phase 4, the feasibility and acceptability of the developed intervention will be assessed among healthcare workers and representatives at the selected hospitals. National consultative workshops in both countries will be conducted to validate the developed intervention with the national technical working groups. Discussion The MRC Framework will be employed to develop and evaluate an intervention to reduce HAIs in two LMICs. This theoretical framework will be used to explore the factors influencing hand hygiene compliance among healthcare workers. The gap analysis results will allow us to develop a comprehensive IPC intervention to reduce HAI incidence in Cambodia and Lao People's Democratic Republic. Findings from this protocol will feed into promising IPC interventions to reduce HAI incidence in other resource-limited settings. Clinical trial registration ClinicalTrial.Gov, identifier NCT05547373.
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Affiliation(s)
- Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Inthavong Nouhak
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | - Sothea Kim
- University of Health Sciences, Phnom Penh, Cambodia
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dyna Khuon
- University of Health Sciences, Phnom Penh, Cambodia
| | - Virya Koy
- Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia
| | - Sovatha Mam
- University of Health Sciences, Phnom Penh, Cambodia
| | - Somphou Sayasone
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | | | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, United States
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Ahadi M, Shams AH, Yadollahi M. Effect of COVID-19 pneumonia infection control protocols on nosocomial infection incidence in trauma patients. Chin J Traumatol 2023; 26:284-289. [PMID: 37268479 PMCID: PMC10174345 DOI: 10.1016/j.cjtee.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/12/2023] [Accepted: 05/04/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE Nosocomial infection is a major threat to the health care system and patient welfare. After the pandemic, new protocols were established in hospitals and communities to protect against the transmission of COVID-19, which may have changed the incidence of nosocomial transmission. This study was conducted to compare the incidence of nosocomial infection before and after the COVID-19 pandemic. METHODS This was a retrospective cohort study performed on trauma patients who were admitted, from May 22, 2018 to November 22, 2021, to the largest level-1 trauma center in Shiraz, Iran (Shahid Rajaei Trauma Hospital). All the trauma patients over 15 years old admitted during the study time were included in this study. Individuals who were declared dead upon arrival were excluded. Patients were evaluated in 2 periods: before the pandemic (May 22, 2018 - February 19, 2020) and after the pandemic (February 19, 2020 - November 22, 2021). Patients were assessed based on demographic information (age, gender, length of hospital stay, and patient outcome), the occurrence of hospital infection, and the type of infection. The analysis was done using SPSS version 25. RESULTS Overall, 60,561 patients were admitted, with a mean age of 40 years. Nosocomial infection was diagnosed in 4.00% (n = 2423) of all admitted patients. The incidence rate of post-COVID-19 hospital-acquired infections decreased by 16.28% (p < 0.001) when compared to before the pandemic; in contrast, surgical site infection (p < 0.001) and urinary tract infection (p = 0.043) were responsible for this change, while hospital-acquired pneumonia (p = 0.568) and bloodstream infection (p = 0.156) were not significantly different. Overall mortality was 1.79%, while 28.52% of all patients with nosocomial infections died. During the pandemic, there was a 25.78% increase (p < 0.001) in the overall incidence rate of mortality, which was also observed among patients with nosocomial infections (17.84%). CONCLUSION The incidence of nosocomial infection has decreased during the pandemic, possibly due to the use of more personal protective equipment and modified protocols after the outbreak. This also explains the difference in the change in incidence rates of nosocomial infection subtypes.
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Affiliation(s)
- Mahsa Ahadi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Hossein Shams
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Yadollahi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hlinkova S, Moraucikova E, Lesnakova A, Strzelecka A, Littva V. Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2415. [PMID: 37685449 PMCID: PMC10487552 DOI: 10.3390/healthcare11172415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a high burden of COVID-19 infections, and hospitals faced greater challenges in preventing and managing CLABSI; (2) Methods: A retrospective analysis of CLABSI data from all patients admitted to adult respiratory intensive care units before and during COVID-19 pandemic was conducted. We followed the guidelines of the Center for Disease Control surveillance methodology for CLABSI. Data were analyzed using STATISTICA 13.1; (3) Results: We analyzed the data of 803 ICU patients hospitalized for 8385 bed days, with 7803 central line days. Forty-five CLABSI events were identified. The CLABSI rate significantly increased during the COVID-19 pandemic compared to before the COVID-19 pandemic (2.81 versus 7.47 events per 1000 central line days, (p < 0.001). The most frequently identified pathogens causing CLABSI were Gram-negative organisms (60.20%). The risk factors found to increase the probability of developing CLABSI were length of stay (OR = 1.080; 95% Cl: 1.057-1.103; p < 0.001) and COVID-19 (OR = 5.485; 95% Cl: 32.706-11.116; p < 0.001). (4) Conclusions: The COVID-19 pandemic was associated with increases in CLABSI in ICUs. These data underscore the need to increase efforts in providing surveillance of CLABSI and implementing infection prevention measures.
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Affiliation(s)
- Sona Hlinkova
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (A.L.); (V.L.)
| | - Eva Moraucikova
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (A.L.); (V.L.)
| | - Anna Lesnakova
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (A.L.); (V.L.)
| | - Agnieszka Strzelecka
- Institute of Health Sciences, Collegium Medicum, Kochanowski University, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland;
| | - Vladimir Littva
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (A.L.); (V.L.)
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Mitchell BG, Stewardson AJ, Kerr L, Ferguson JK, Curtis S, Busija L, Lydeamore MJ, Graham K, Russo PL. The incidence of nosocomial bloodstream infection and urinary tract infection in Australian hospitals before and during the COVID-19 pandemic: an interrupted time series study. Antimicrob Resist Infect Control 2023; 12:61. [PMID: 37400858 DOI: 10.1186/s13756-023-01268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a significant impact on healthcare including increased awareness of infection prevention and control (IPC). The aim of this study was to explore if the heightened awareness of IPC measures implemented in response to the pandemic influenced the rates of healthcare associated infections (HAI) using positive bloodstream and urine cultures as a proxy measure. METHODS A 3 year retrospective review of laboratory data from 5 hospitals (4 acute public, 1 private) from two states in Australia was undertaken. Monthly positive bloodstream culture data and urinary culture data were collected from January 2017 to March 2021. Occupied bed days (OBDs) were used to generate monthly HAI incidence per 10,000 OBDs. An interrupted time series analysis was undertaken to compare incidence pre and post February 2020 (the pre COVID-19 cohort and the COVID-19 cohort respectively). A HAI was assumed if positive cultures were obtained 48 h after admission and met other criteria. RESULTS A total of 1,988 bloodstream and 7,697 urine positive cultures were identified. The unadjusted incident rate was 25.5 /10,000 OBDs in the pre-COVID-19 cohort, and 25.1/10,000 OBDs in the COVID-19 cohort. The overall rate of HAI aggregated for all sites did not differ significantly between the two periods. The two hospitals in one state which experienced an earlier and larger outbreak demonstrated a significant downward trend in the COVID-19 cohort (p = 0.011). CONCLUSION These mixed findings reflect the uncertainty of the effect the pandemic has had on HAI's. Factors to consider in this analysis include local epidemiology, differences between public and private sector facilities, changes in patient populations and profiles between hospitals, and timing of enhanced IPC interventions. Future studies which factor in these differences may provide further insight on the effect of COVID-19 on HAIs.
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Affiliation(s)
- Brett G Mitchell
- School of Nursing, Avondale University, Cooranbong, NSW, 2265, Australia
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia
- Gosford Hospital, Central Coast Local Health District, NSW, 2250, Australia
| | - Andrew J Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - Lucille Kerr
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia
- Department of Nursing Research, Cabrini Institute, Malvern, VIC, 3144, Australia
- School of Nursing and Midwifery, Deakin University, Burwood, Australia
| | - John K Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, 2310, NSW, Australia
- University of Newcastle, Callaghan, NSW, 2308, Australia
- Infection Prevention Service, Hunter New England Health, John Hunter Hospital, NSW, 2310, Australia
| | - Stephanie Curtis
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - Ljoudmila Busija
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Michael J Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Melbourne, 3800, Australia
| | - Kirsty Graham
- Infection Prevention and Control, Central Coast Local Health District, Gosford, NSW, 2250, Australia
| | - Philip L Russo
- School of Nursing, Avondale University, Cooranbong, NSW, 2265, Australia.
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia.
- Department of Nursing Research, Cabrini Institute, Malvern, VIC, 3144, Australia.
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11
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Chang Z, An L, Lei M, Song Z, Deng J, Tang R, Cheng ZJ, Wu W, Sun B. The genetic associations of COVID-19 on genitourinary symptoms. Front Immunol 2023; 14:1216211. [PMID: 37415973 PMCID: PMC10319997 DOI: 10.3389/fimmu.2023.1216211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Background Recently emerged reports indicated that patients with coronavirus disease 2019 (COVID-19) might experience novo genitourinary symptoms after discharge. Nevertheless, the causal associations and underlying mechanisms remain largely unclear. Methods Genome-wide association study (GWAS) statistics for COVID-19 and 28 genitourinary symptoms with consistent definitions were collected from the COVID-19 Host Genetic Initiative, FinnGen, and UK Biobanks. Mendelian randomization (MR) analyses were applied to explore the causal effects of COVID-19 on genitourinary symptoms by selecting single-nucleotide polymorphisms as instrumental variables. Meta-analyses were conducted to evaluate the combined causal effect. Molecular pathways connecting COVID-19 and its associated disorders were evaluated by weighted gene co-expression network analysis (WGCNA) and enrichment analyses to extract insights into the potential mechanisms underlying the connection. Results The MR and meta-analyses indicated that COVID-19 was causally associated with increased risk for calculus of the lower urinary tract (LUTC, OR: 1.2984 per doubling in odds of COVID-19, 95% CI: 1.0752-1.5680, p = 0.007) and sexual dysfunction (SD, OR: 1.0931, 95% CI: 1.0292-1.1610, p = 0.004). Intriguingly, COVID-19 might exert a slight causal protective effect on the progression of urinary tract infections (UTIs) and bladder cancer (BLCA). These results were robust to sensitivity analyses. Bioinformatic analyses indicated that the inflammatory-immune response module may mediate the links between COVID-19 and its associated disorders at the molecular level. Conclusions In response to post-COVID-19 symptoms, we recommend that COVID-19 patients should strengthen the prevention of LUTC and the monitoring of sexual function. Meanwhile, the positive effects of COVID-19 on UTIs and BLCA should attach equal importance.
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Affiliation(s)
- Zhenglin Chang
- Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Allergy and Clinical Immunology, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Laboratory, Guangzhou Laboratory, Guangzhou, China
| | - Lingyue An
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Min Lei
- Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenfeng Song
- Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Allergy and Clinical Immunology, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Deng
- Department of General Surgery, Ziyang First People’s Hospital, Ziyang, Sichuan, China
| | - Ruizheng Tang
- Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhangkai J. Cheng
- Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Allergy and Clinical Immunology, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Laboratory, Guangzhou Laboratory, Guangzhou, China
| | - Wenqi Wu
- Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Baoqing Sun
- Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Allergy and Clinical Immunology, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Laboratory, Guangzhou Laboratory, Guangzhou, China
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12
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Yilmaz Hanci S. Classics of infectious diseases: A bibliometric analysis of the 100 most cited articles. Medicine (Baltimore) 2023; 102:e33607. [PMID: 37115058 PMCID: PMC10145723 DOI: 10.1097/md.0000000000033607] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
In our study, the 100 most cited publications in the field of "Infectious Diseases" in the WOS database were evaluated bibliometrically. "Web of Science" database "advanced mode" feature was used. A search was made in the field of "Infectious Diseases." The top 100 most cited publications were determined. The total number of citations of the publications, the annual number of citations, the authors, the information of the study and the journal were analyzed. There were a total of 552,828 publications in the field of "Infectious Diseases" in the WOS between 1975 and 2023. The total citation average of the 100 most cited publications was 2246.02 ± 2165.35 and the annual citation average was 208.04 ± 215.00. The first 3 subjects in the first hundred articles were listed as antibiotic resistance (21%), coronavirus disease 2019 (COVID-19) (17%) and gram positive agents (10%). The first 3 journals in which the studies were published the most were determined as "Clinical Infectious Diseases" (33%), "Lancet Infectious Diseases" (20%), and "Emerging Infectious Diseases" (9%). A significant relationship was found between the subject of the study, the quarter (Q) category of the journal, the continent of authors and publisher, the funding status, the year of publication, the open access status and the number of citations per year (P < .0001). Our study is the first to analyze the top 100 most cited studies in the field of "Infectious Diseases" in the literature and their citation characteristics. Most of the most cited studies on the subject were on antibiotic resistance. The study subject, author, journal, publisher and publication access features, funding status and publication year affect the number of citations per year.
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Affiliation(s)
- Sevgi Yilmaz Hanci
- Specialist of Microbiology and Clinical Microbiology, Health Sciences University, İzmir Tepecik Training and Research Hospital, Microbiology and Clinical Microbiology Laboratory, Konak, Izmir, Turkey
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Alaidaroos OA, Almuhaydib MN, Alhossan MA, Aldossari AN, Fallatta MO, Alotaibi SM, Alowid FK, Salem AA, Alsaygh KA, Alshammary HS. Unexpected Benefits of Coronavirus Disease 2019: Impact of Coronavirus Disease 2019 Pandemic on Surgical Site Infection: A Systematic Review and Meta-Analysis. Surg Infect (Larchmt) 2023; 24:119-130. [PMID: 36847343 DOI: 10.1089/sur.2022.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Background: We aimed to summarize and synthesize the current evidence regarding the indirect impact of the coronavirus disease 2019 (COVID-19) pandemic and its associated measures on the surgical site infection (SSI) rate compared with the pre-pandemic period. Methods: A computerized search was conducted on MEDLINE via PubMed, Web of Science, and Scopus using the relevant keywords. Two-stage screening and data extraction were done. The National Institutes of Health (NIH) tools were used for the quality assessment. The Review Manager 5.4.1 program was used for the analysis. Results: Sixteen articles (n = 157,426 patients) were included. The COVID-19 pandemic and lockdown were associated with reduced risk of SSIs after surgery (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.56-0.75; p < 0.00001) and (OR, 0.49; 95% CI, 0.29-0.84; p = 0.009), respectively. There was no significant reduction in the SSIs rate after applying the extended use of masks (OR, 0.73; 95% CI, 0.30-1.73; p = 0.47). A reduction in the superficial SSI rate during the COVID-19 pandemic compared with the pre-COVID-19 pandemic period was observed (OR, 0.58; 95% CI, 0.45-0.75; p < 0.0001). Conclusions: The current evidence suggests that the COVID-19 pandemic may have some unexpected benefits, including improved infection control protocols, which resulted in reduced SSI rates, especially superficial SSIs. In contrast to extended mask use, the lockdown was associated with reduced rates of SSIs.
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Affiliation(s)
| | | | - Mashari Ahmed Alhossan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulkarem Naif Aldossari
- College of Medicine, Najran University, Najran, Saudi Arabia.,Emergency Department, King Khalid Hospital, Najran, Saudi Arabia
| | - Mawadda Omar Fallatta
- College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.,General Surgery Department, Althaghr Hospital, Jeddah, Saudi Arabia
| | | | - Fay Khalid Alowid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Zand F, Vakili H, Asmarian N, Masjedi M, Sabetian G, Nikandish R, Shafiee E, Tabatabaei Esfehani A, Azadi F, Sanaei Dashti A. Unintended impact of COVID-19 pandemic on the rate of catheter related nosocomial infections and incidence of multiple drug resistance pathogens in three intensive care units not allocated to COVID-19 patients in a large teaching hospital. BMC Infect Dis 2023; 23:11. [PMID: 36609225 PMCID: PMC9821351 DOI: 10.1186/s12879-022-07962-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 12/21/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. METHODOLOGY The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March-October 2019) and after (March-October 2020) the onset of COVID-19 pandemic in three ICU's, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens. RESULTS Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI 0.43-1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI 0.22-1.98, P = 0.469). CONCLUSION The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii.
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Affiliation(s)
- Farid Zand
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hedayatollah Vakili
- grid.412571.40000 0000 8819 4698Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoor Masjedi
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- grid.412571.40000 0000 8819 4698Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Nikandish
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Shafiee
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Tabatabaei Esfehani
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Azadi
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Sanaei Dashti
- grid.412571.40000 0000 8819 4698Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Tetteh-Quarcoo PB, Afutu E, Wiafe-Ansong M, Kotey FCN, Dayie NTKD, Donkor ES, Ahenkorah J, Udofia EA, Ayeh-Kumi PF, Dzudzor B, Asiedu-Gyekye IJ. Contrasting Hygiene-Related Gastrointestinal Infections and Stress-Related Diseases at a Primary Health Care Facility within a Sub-Saharan African City: Before and during the COVID-19 Pandemic. Diseases 2022; 11:diseases11010002. [PMID: 36648867 PMCID: PMC9844452 DOI: 10.3390/diseases11010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/27/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND With the advent of the COVID-19 pandemic caused by SARS-CoV-2, protocols such as social distancing and upscaling of hygiene practices were implemented to limit the spread of the disease. Meanwhile, along with COVID-19 came stress due to restrictions on movement, trade and transport, and closure of schools, among others. AIM This study compared the prevalence of hygiene-related gastrointestinal infections and stress-related diseases before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic. METHODOLOGY This was a retrospective single-center review of deidentified patient data from the Korle Bu Polyclinic, Accra, Ghana. RESULTS Comparing the pre-COVID-19 era to the COVID-19 era, there was a statistically nonsignificant change in the number of cases and prevalence of gastroenteritis and enteric fever (p = 0.084 and 0.081, respectively), although for gastroenteritis, the prevalence was higher for the pre-COVID-19 era compared to during COVID-19 by 1.8 per 1000 cases, while that of enteric fever was higher during the COVID-19 era compared to the pre-COVID-19 era by 1.0 per 1000 cases. Of the stress-related diseases, statistically significant increases in the prevalence of anxiety disorders (p = 0.028), insomnia (p = 0.001), and headache (p = 0.010), were noted, with 2.3, 5.5, and 2.4 per 1000 cases, respectively. There were more female cases than male cases recorded for depression (p = 0.001), headache (p = 0.010), and hypertension (p = 0.001) during the pandemic, and these were statistically significant. CONCLUSION During the pandemic, a significant increase in the prevalence of stress-related diseases was observed. However, a statistically nonsignificant change was recorded for gastrointestinal infections, with females reporting more of these disorders. Consequently, it is important to strengthen the capacity for managing stress-related conditions alongside diseases that cause pandemics when they arise.
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Affiliation(s)
- Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Emmanuel Afutu
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Madonna Wiafe-Ansong
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- FleRhoLife Research Consult, Teshie, Accra P.O. Box TS 853, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Patrick F. Ayeh-Kumi
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Isaac Julius Asiedu-Gyekye
- University of Ghana School of Pharmacy, College of Health Sciences, University of Ghana, Accra P.O. Box KB 52, Ghana
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Amer F, Hammoud S, Khatatbeh H, Lohner S, Boncz I, Endrei D. A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic. BMC Health Serv Res 2022; 22:621. [PMID: 35534850 PMCID: PMC9081670 DOI: 10.1186/s12913-022-07863-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction. AIM This systematic review aims to identify all the perspectives, dimensions, and KPIs that are vital and most frequently used by health care managers in BSC implementations. METHODS This systematic review adheres to PRISMA guidelines. The PubMed, Embase, Cochrane, and Google Scholar databases and Google search engine were inspected to find all implementations of BSC at HCO. The risk of bias was assessed using the nonrandomized intervention studies (ROBINS-I) tool to evaluate the quality of observational and quasi-experimental studies and the Cochrane (RoB 2) tool for randomized controlled trials (RCTs). RESULTS There were 33 eligible studies, of which we identified 36 BSC implementations. The categorization and regrouping of the 797 KPIs resulted in 45 subdimensions. The reassembly of these subdimensions resulted in 13 major dimensions: financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, health care workers' (HCWs) scientific development error-free and safety, time, HCW-centeredness, patient-centeredness, technology, and information systems, community care and reputation, HCO building, and communication. On the other hand, this review detected that BSC design modification to include external and managerial perspectives was necessary for many BSC implementations. CONCLUSION This review solves the KPI categorization dilemma. It also guides researchers and health care managers in choosing dimensions for future BSC implementations and performance evaluations in general. Consequently, dimension uniformity will improve the data sharing and comparability among studies. Additionally, despite the pandemic negatively influencing many dimensions, the researchers observed a lack of comprehensive HCO performance evaluations. In the same vein, although some resulting dimensions were assessed separately during the pandemic, other dimensions still lack investigation. Last, BSC dimensions may play an essential role in tackling the COVID-19 pandemic. However, further research is required to investigate the BSC implementation effect in mitigating the pandemic consequences on HCO.
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Affiliation(s)
- Faten Amer
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
- Faculty of Health Sciences, Institute for Health Insurance, University of Pécs, Pécs, Hungary.
| | - Sahar Hammoud
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Szimonetta Lohner
- Clinical Center of the University of Pécs, Medical School, Cochrane Hungary, University of Pécs, Pécs, Hungary
| | - Imre Boncz
- Faculty of Health Sciences, Institute for Health Insurance, University of Pécs, Pécs, Hungary
| | - Dóra Endrei
- Faculty of Health Sciences, Institute for Health Insurance, University of Pécs, Pécs, Hungary
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Putra A, Kamil H, Mayasari P, Annur B.F, Yuswardi Y. Do the Nurse Practice the Five Moments for Hand Hygiene? An Observational Study during Pandemic COVID-19. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION: Healthcare-associated infections (HAIs) are frequently found in patients worldwide each year with varying rates. In November 2021, there were 23 incidents of nosocomial infection at a General Hospital in Banda Aceh. Of these incidents, eight occurred in the surgical inpatient room. Nurses have a significant role in reducing the number of hospital infections. Nurses must utilize the knowledge and skills of nursing practice to facilitate patient recovery while minimizing infection-related complications in patients.
AIM: This clinical observation aims to identify the practice of 5 moments of hand hygiene in the surgical inpatient ward, General Hospital Banda Aceh.
METHODS: This clinical observation aims to identify the practice of 5 moments of hand hygiene in the surgical inpatient ward, General Hospital Banda Aceh. This clinical observation with a population of 26 nurses. A sample of 16 nurses was obtained through the incidental sampling method. The tool used to collect data is in the form of a hand hygiene observation sheet that was observed at five moments according to World Health Organization (WHO) standards.
RESULTS: The five-moment hand hygiene showed that the nurse hand hygiene practice was 68.7%-100%. The sequent percentage values of practicing hand hygiene are: 68.7% of nurses do not apply hand hygiene before contact with patients; 75% of nurses did not apply hand hygiene before aseptic action; 75% of nurses apply hand hygiene after contact with the patient's environment; 93.7% of nurses apply hand hygiene after contact with patients, and 100% of nurses apply hand hygiene after being exposed to the patient's body fluids. Finally, only four respondents (25%) thoroughly applied five hand hygiene moments.
CONCLUSIONS: The leadership role of the head nurse is needed to optimize the practicing of hand hygiene in the hospital inpatient room, which is shown through role models, continuous supervision, and evaluation. In addition, good infrastructure is also needed to support these activities.
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Baiamonte D, Mannone P, Giannarini G, DI Gregorio G, Tulone G, Biancolini R, Giaimo R, Vella M, Pavan N, Ficarra V, Bartoletti R, Simonato A. Role of hygienic measures against COVID-19 on infective complications after urological interventions. Minerva Urol Nephrol 2022; 74:124-125. [PMID: 35272454 DOI: 10.23736/s2724-6051.22.04756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Davide Baiamonte
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy -
| | - Piero Mannone
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Gianluca Giannarini
- Unit of Urology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Gianpaolo DI Gregorio
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tulone
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Roberto Biancolini
- Department of Urology, San Bartolomeo a Sarzana Hospital, Azienda Sociosanitaria Ligure5, La Spezia, Italy
| | - Rosa Giaimo
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Marco Vella
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Nicola Pavan
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Vincenzo Ficarra
- Section of Urology, Gaetano Barresi Department of Human and Pediatric Pathology, University of Messina, Messina, Italy
| | - Riccardo Bartoletti
- Unit of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy
| | - Alchiede Simonato
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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19
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Comparing the Occurrence of Healthcare-Associated Infections in Patients with and without COVID-19 Hospitalized during the Pandemic: A 16-Month Retrospective Cohort Study in a Hospital Intensive Care Unit. J Clin Med 2022; 11:jcm11051446. [PMID: 35268538 PMCID: PMC8910983 DOI: 10.3390/jcm11051446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has increased the healthcare-associated infection (HAI) risk in intensive care unit (ICU) patients. However, a comparison between patients with and without COVID-19 in terms of HAI incidence has been rarely explored. In this study, we characterized the occurrence of HAI among patients with and without COVID-19 admitted to the ICU of the Umberto I hospital of Rome during the first 16 months of the pandemic and also identified risk factors for HAI acquisition. Patients were divided into four groups according to their ICU admission date. A multivariable conditional risk set regression model for multiple events was constructed for each admission period. Adjusted hazard ratios and 95% confidence intervals were calculated. Overall, 352 COVID-19 and 130 non-COVID-19 patients were included, and a total of 361 HAIs were recorded. We found small differences between patients with and without COVID-19 in the occurrence and type of HAI, but the infections in the two cohorts mostly involved different microorganisms. The results indicate that patient management was likely an important factor influencing the HAI occurrence during the pandemic. Effective prevention and control strategies to reduce HAI rates should be implemented.
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20
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Comparison of Death Anxiety, Death Obsession, and Humor in Nurses and Medical Emergency Personnel in COVID-19 Pandemic. J Emerg Nurs 2022; 48:559-570. [PMID: 35690485 PMCID: PMC8894800 DOI: 10.1016/j.jen.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/24/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022]
Abstract
Introduction COVID-19 has created numerous challenges for the health system. Nurses and medical emergency personnel are at the forefront of fighting COVID-19 and exposed to psychological disorders such as death anxiety and death obsession. Humor is a defense and coping mechanism against the anxiety and obsession associated with death. This study aimed to compare death anxiety, death obsession, and humor among nurses and medical emergency personnel during the COVID-19 pandemic. Methods This descriptive cross-sectional study was conducted with 230 nurses and medical emergency personnel. To collect data, the Templer death anxiety scale, death obsession scale, and humor styles questionnaire were used. SPSS 19 was used for data analysis. The significance level was considered at P < .05. Results Mean and standard deviation of death anxiety in the nurses and medical emergency personnel were 6.86 (4.04) and 5.68 (3.57), respectively; these values for death obsession were 29.82 (12.30) and 25.30 (12.66) and for humor 116.75 (30.87) and 118.48 (24.66), respectively. The nurses had significantly higher death anxiety (t = 2.33, P = .02) and death obsession (t = −2.68, P = .008) than the medical emergency personnel; moreover, there was no significant relationship among humor, death anxiety (r = .11, P = .10), and death obsession (r = .07, P = .31) in nurses and emergency personnel. Discussion The results of this study showed that the levels of death anxiety and death obsession were higher in the nurses than the medical emergency personnel. There was no significant difference between the hospital nurses and medical emergency personnel in terms of humor.
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21
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Kim SH, Choi Y, Lee D, Lee H, Kim JH, Choi ES, Jung YM, Lee J, Choe PG, Lee JY, Do Y, Park CW, Park JS, Jun JK, Lee SM, Lee JY. Impact of COVID-19 on pregnant women in South Korea: focusing on prevalence, severity, and clinical outcomes. J Infect Public Health 2022; 15:270-276. [PMID: 35066387 PMCID: PMC8761582 DOI: 10.1016/j.jiph.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 02/09/2023] Open
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22
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Mitra M, Ghosh A, Pal R, Basu M. Prevention of hospital-acquired infections: A construct during Covid-19 pandemic. J Family Med Prim Care 2021; 10:3348-3354. [PMID: 34760756 PMCID: PMC8565103 DOI: 10.4103/jfmpc.jfmpc_742_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic. Objectives: This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers. Materials and Methods: This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs. Results: The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend. Conclusion: Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.
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Affiliation(s)
- Manasij Mitra
- Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
| | - Amrita Ghosh
- Department of Biochemistry, Medical College and Hospital, 88 College Street, Kolkata, West Bengal, India
| | - Ranabir Pal
- Department of Community Medicine, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
| | - Maitraye Basu
- Department of Biochemistry, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
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23
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Watson A, Barnard H, Antoine-Pitterson P, Jones B, Turner AM, Mukherjee R. The impact of COVID-19 on acute non-invasive ventilation services: A case for change. Respirology 2021; 26:1106-1109. [PMID: 34605125 PMCID: PMC8662065 DOI: 10.1111/resp.14156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Alastair Watson
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Hannah Barnard
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pearlene Antoine-Pitterson
- Department of Respiratory Medicine, Birmingham Heartlands Hospital (Part of University Hospitals Birmingham), Birmingham, UK
| | - Bethany Jones
- Department of Respiratory Medicine, Birmingham Heartlands Hospital (Part of University Hospitals Birmingham), Birmingham, UK
| | - Alice M Turner
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Department of Respiratory Medicine, Birmingham Heartlands Hospital (Part of University Hospitals Birmingham), Birmingham, UK
| | - Rahul Mukherjee
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Department of Respiratory Medicine, Birmingham Heartlands Hospital (Part of University Hospitals Birmingham), Birmingham, UK
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24
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Molecular Characterization of Isolated Multidrug-Resistant Bacteria from Tertiary Care Hospitals of Ahmedabad: A Comparison Study Between Previous to COVID-19 and Current Scenario. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.2.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Hospital Acquired Infections (HAIs) are a significant concern for healthcare setups, as it increases the overall cost of treatment, patients stay in hospitals, making them susceptible to secondary and tertiary infections and, sometimes, mortality1. To prevent or control HAIs, evaluating the organisms isolated from the critically maintained areas is considered of epitome importance and everlasting practice in the healthcare industry. Identifying such organisms and screening them for antibiotic resistance is mandatory, but it also helps professionals understand colonization trends. Sensitive areas of healthcare setups were screened monthly from years 2017 to 2020. A total of 4400 samples of hospital hygiene, e.g., intravenous drip stands, ventilator surface, anesthetist’s trolley, patient’s bed, instrument trolley, etcetera, were collected. Isolated organisms were cultured and screened using the CLSI technique.
E. coli, Pseudomonas spp., and Klebsiella spp. were found in both previous to COVID current samples. Multidrug-resistant organisms were subjected to molecular characterization to detect the presence of carbapenem genes. Evaluation data of both pre-and during Coronavirus Disease or COVID-19 were compared. The prevalence of pathogenic (Klebsiella spp., E. coli, and Pseudomonas spp.) and non-pathogenic (Staphylococcus aureus and Bacillus spp.) strains in healthcare setups decreased drastically (Klebsiella spp. from 80% to 20%, E.coli from 90% to 10% and Pseudomonas spp. from 80% to 20%). It is possible only because of the awareness in non-specialists and healthcare workers due to the unforeseen critical situation proving to be a blessing for the future generation.
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25
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Ghali H, Ben Cheikh A, Bhiri S, Khefacha S, Latiri HS, Ben Rejeb M. Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211067930. [PMID: 34910605 PMCID: PMC8689600 DOI: 10.1177/00469580211067930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. AIM To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. METHODS The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. RESULTS Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% (P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). CONCLUSION Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.
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Affiliation(s)
- Hela Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Asma Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Sana Bhiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Selwa Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Houyem Said Latiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Mohamed Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
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