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/).
M, B., A, M., G, F., Rms, L., Mc, L. R., F, D., A, 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., Cannavò, 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., Cannistrà, 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., Calà, O., Di 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., 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, <<THE JOURNAL OF HOSPITAL INFECTION>>, 2023; 140 (n/a): 124-131. [doi:10.1016/j.jhin.2023.07.021] [https://hdl.handle.net/10807/304585]
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
Pulvirenti, Alessia;Di Benedetto, Adriano;Antonelli, Massimo;Laurenti, Patrizia;Arrigoni, Chiara;
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. (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.