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. <(c)> 2023 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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 / Barchitta, M.; Maugeri, A.; Favara, G.; Lio, R. M. S.; La Rosa, M. C.; D'Ancona, F.; Agodi, A.; Murgia, P.; Masia, M. D.; Mura, I.; Brusaferro, S.; Arnoldo, L.; Di Stefano, C.; Lucchese, F.; Lugano, M.; Tardivo, S.; Moretti, F.; Bernasconi, M. O.; Pappalardo, F.; Pasquarella, C.; Sicoli, E.; Montagna, M. T.; Caggiano, G.; De Giglio, O.; Fenaroli, S.; Squeri, R.; Cannavo, G.; Pulvirenti, A.; Catalano, S.; Mattaliano, A. R.; Castiglione, G.; Astuto, M.; La Camera, G.; Panascia, E.; Longhitano, A. M.; Scrofani, G.; Gallea, M. R.; Civello, P.; Milazzo, M.; Calamusa, G.; Giarratano, A.; Di Benedetto, A.; Rizzo, G. M. G.; Manta, G.; Angelone, C.; Mancuso, R.; Tetamo, R.; Mella, L. M.; Dei, I.; Pandiani, I.; Cannistra, A.; Piotti, P.; Girardis, M.; Barbieri, A.; Borracino, S.; Palermo, R.; Di Stefano, D.; Colombo, A.; Romeo, A.; Minerva, M.; Fabiani, L.; Marinangeli, F.; D'Errico, M. M.; Donati, A.; Domizi, R.; Saglimbene, S. T.; Bianco, A.; Vittori, C.; Orsi, G. B.; Scibilia, M.; Cala, O.; Giacinto, I.; Amatucci, M. R.; Principi, T.; Di Fabio, G.; Gobbini, V.; Olori, M. P.; Antonelli, M.; Laurenti, P.; Condorelli, L.; Ingala, F.; Russo, S.; Costa, P.; Canonico, L.; Farruggia, P.; Cristina, M. L.; Sartini, M.; Arrigoni, C.; Galassi, I.; Vinci, V. M.. - In: THE JOURNAL OF HOSPITAL INFECTION. - ISSN 0195-6701. - 140:(2023), pp. 124-131. [10.1016/j.jhin.2023.07.021]
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
Masia M. D.Membro del Collaboration Group
;
2023-01-01
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. <(c)> 2023 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
