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BIBTEX RIS

Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort

2025; BioMed Central; Volume: 29; Issue: 1 Linguagem: Inglês

10.1186/s13054-024-05203-8

1466-609X

Bruno Martins Tomazini, Bruno Adler Maccagnan Pinheiro Besen, Renato Hideo Nakagawa Santos, Antônio Paulo Nassar, Thabata Veiga, Viviane Bezerra Campos, Samira Martins Tokunaga, Elton Sousa Santos, Letícia Galvão Barbante, Renato da Costa Maia, Flávia Cristina Soares Kojima, Ligia Nasi Laranjeira, Leandro Utino Taniguchi, Roberta Muriel Longo Roepke, Cristiano Augusto Franke, Luciana Coelho Sanches, Lívia Maria Garcia Melro, Israel Silva Maia, Vicente Souza-Dantas, Rodrigo Cruvinel Figueiredo, Meton Soares de Alencar Filho, Vivian Menezes Irineu, Wilson José Lovato, Cassio Luis Zandonai, Flávia Ribeiro Machado, Beatriz Arns, Giovanna Marsola, Viviane Cordeiro Veiga, Adriano José Pereira, Alexandre Biasi Cavalcanti, Silvana Soares dos Santos, Juliana Chaves Coelho, Michelle Tereza Sousa, Bruna Azevedo, Luciana Macedo da Silva Gavinho, Alaís Brito Nascimento, Rodrigo Barbosa Cerantola, Itallo de Lima Neves, Vanessa Cristina de Aquino Leão, Rodrigo Morel Vieira de Melo, Luane Lopes Cavalcante Gomes, Vladimir Miguel Spirale, Roberta Schiavon Nogueira, Lúcio Couto de Oliveira, Daniela Cunha de Oliveira, Marianna Deway Andrade Dracoulakis, Natalia Alvaia, Andre Luiz Nunes Gobatto, Carolaine Bomfim de Oliveira, Cíntia Magalhães Carvalho Grion, Cláudia Maria Dantas de Maio Carrilho, Cláudia Fernanda de Lacerda Vidal, Fernanda Lopes de Albuquerque Rodrigues, Thiago Lisboa, Cristófer Farias da Silva, Leticia Pierini, Antônio Carlos da Silva, Sheila Mara Bezerra de Oliveira, Maria Brandão Tavares, Igor das Virgens Santana, Tatiana Gozzi Pancev Toledo, Fabio de Carvalho Mauricio, Bianca Ramos Ferronato, André Sant’Ana Machado, Leticia Capeletti, Marina Peres Bainy, Gabriela Teixeira, Dagoberta Alves Vieira Beduhn, Durval Ferreira Fonseca Pedroso, Priscilla Yoshiko Sawada, Caio Cesar Ferreira Fernandes, Juliana Mazzei Garcia, R. Malta, Cindy Medici Toscano Rozetti, Pedro Aniceto Nunes Neto, Valéria Chagas Pereira, Emerson Boschi, Viviane Aline Buffon, Tássio Breno de Sousa Lopes Lavôr, Marcela Dutra, Mário Reis Álvares‐da‐Silva, Leila Rezegue de Moraes Rego, Adria Vanessa da Silva, Vivian Menezes Irineu, Vanessa Correa, Rodrigo Cruvinel Figueiredo, Jackelyne Lopes Silva, Jussara A. Arraes, Meton Soares de Alencar Filho, M. Medeiros, Francielle Constantino Pereira, Fernanda Borges Salgado, Vicente Souza-Dantas, Priscilla Alves Barreto, Israel Silva Maia, Cassio Luis Zandonai, Fábio Holanda Lacerda, René Rodrigues, Luana Pontes Oliveira, Eliene Sá Sodré Filho, João Lucidio Lobato Paes, Mário Reis Álvares‐da‐Silva, Débora Maria Brito de Pinho, Carolina Miranda, Lívia Maria Garcia Melro, Priscila Freitas das Neves Gonçalves, Alfred White Franklin, Rafael Botelho Foernges, Maite Souza Magdalena, Felipe Dal‐Pizzol, Danusa de Castro Damasio, Roberta Machado de Souza, Larissa Liz Cardoso de Araújo, Flávia Ribeiro Machado, Maria Aparecida de Souza, Nicole Alberti Golin, Juliana Giacomazzi, Joana D’Arc Vila Nova Jatobá, Maria Tereza Farias de Moura, Luís Eduardo Miranda Paciência, Elaine Silva Bueno, Eliana Bernadete Caser, Larissa Zuqui Ribeiro, Diego Meireles Duarte, Rejane Martins Prestes, Glícia Cardoso Nascimento, Valéria Paes Lima, Kamilla Grasielle Nunes da Silva, Roberta Lacerda Almeida de Miranda Dantas, Eliane Pereira Silva, Hugo Corrêa de Andrade Urbano, Danielle Conceição Aparecida Moreira, Pedro Kurtz, Cássia Righy, Everton Macêdo Silva, Julival Ribeiro, Cláudio Dornas de Oliveira, Raquel Caldeira Brant Santiago, Jorge Luiz da Rocha Paranhos, Iany Grinezia da Silva Wiermann, Thiago Gomes Romano, Daniel Cubos,

Sepsis Diagnosis and Treatment

Limited data is available to evaluate the burden of device associated healthcare infections (HAI) [central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP)] in low and-middle-income countries. Our aim is to investigate the population attributable mortality fraction and the absolute mortality difference of HAI in a broad population of critically ill patients from Brazil. Multicenter cohort study from September 2019 to December 2023 with prospective individual patient data collection. VAP, CLABSI, and CAUTI were diagnosed by each center in accordance with Brazilian regulatory agency guidance. If a patient fulfilled all diagnostic criteria, he was deemed to have Confirmed HAI. An adjusted disability multistate model was used to evaluate the population attributable in-hospital mortality fraction (PAF) and the absolute in-hospital mortality difference (AMD). A total of 128,247 patients were included. 4066 (3.2%) distinct patients had at least one diagnosis of HAI (1493 CLABSI, 433 CAUTI, 2742 VAP, and 435 patients with more than one HAI) during the ICU stay. The PAF was 3.89% (95% CI 3.68–4.11%) for HAI, 2.16% (2.05–2.33%) for VAP, 1.2% (1.08–1.32%) for CLABSI, 0.11% (0.07–0.16%) for CAUTI, and 0.33% (0.26–0.4%) for ≥ 2 HAI. The AMD for HAI was 33.69% (95% CI 32.27–35.33%), 29.01% (27.15–30.98%) for VAP, 31.64% (29.3–34.81%) for CLABSI, 9.94% (3.88–15.54%) for CAUTI and 35.6% (28.93–42.99%) for ≥ 2 HAI. Device-associated HAI significantly contribute to hospital mortality and impose a high excess risk of death for critically ill patients.