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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

2023; Elsevier BV; Volume: 140; Linguagem: Inglês

10.1016/j.jhin.2023.07.021

1532-2939

Martina Barchitta, Andrea Maugeri, Giuliana Favara, Roberta Magnano San Lio, M C La Rosa, Fortunato D’Ancona, Antonella Agodi, Paola Murgia, María Dolores Masiá, I Mura, Silvio Brusaferro, Luca Arnoldo, Carla Di Stefano, Fernando Lucchese, Marı́a Cristina Lugano, Stefano Tardivo, Francesca Moretti, Mara Bernasconi, Francesco Pappalardo, Cesira Pasquarella, Ennio Sicoli, Maria Teresa Montagna, Giuseppina Caggiano, O. De Giglio, Salesia Fenaroli, Raffaele Squeri, Giuseppe Cannavò, Alfredo Pulvirenti, Samantha Catalano, Anna Rita Mattaliano, Giacomo Castiglione, Marinella Astuto, Giuseppa La Camera, E Panascia, Anna Maria Longhitano, Giorgio Scrofani, M.R. Gallea, Pietro Civello, Michele Milazzo, Giuseppe Calamusa, Antonino Giarratano, A. Di Benedetto, G. Rizzo, Giuseppe Manta, C. Angelone, Roberta Mancuso, Romano Tetamo, L. Mella, Ignazio Dei, Irene Pandiani, Antonino Cannistrà, Patrizia Piotti, Massimo Girardis, Alberto Barbieri, Savino Borracino, Roberto Palermo, D. Di Stefano, Riccardo Colombo, Anthony A. Romeo, Mariachiara Minerva, Leila Fabiani, Franco Marinangeli, Marcello Mario D’Errico, Abele Donati, Roberta Domizi, Sebastiana Saglimbene, Aida Bianco, Cesare Vittori, Giovanni Battista Orsi, M. Scibilia, Olivier Cala, Ida Di Giacinto, M.R. Amatucci, Tania Principi, Giovanni Di Fabio, V. Gobbini, Maria Patrizia Olori, Massimo Antonelli, Patrizia Laurenti, Luigi Condorelli, F. Ingala, Salvatore Russo, Elı́sio Costa, L. Canonico, Patrizia Farruggia, Míriam Cristina, Marina Sartini, Cristina Arrigoni, I. Galassi, Viviana Vinci,

Patient Satisfaction in Healthcare

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.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.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.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%).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.