Predictors and outcomes of healthcare-associated infections among patients with COVID-19 admitted to intensive care units in Punjab, Pakistan; findings and implications

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Mustafa, Zia Ul and Tariq, Sania and Iftikhar, Zobia and Meyer, Johanna C. and Salman, Muhammad and Mallhi, Tauqeer Hussain and Khan, Yusra Habib and Godman, Brian and Seaton, R. Andrew (2022) Predictors and outcomes of healthcare-associated infections among patients with COVID-19 admitted to intensive care units in Punjab, Pakistan; findings and implications. Antibiotics, 11 (12). 1806. ISSN 2079-6382 (https://doi.org/10.3390/antibiotics11121806)

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Abstract

Healthcare-associated infections (HAIs) have a considerable impact on morbidity, mortality and costs. The COVID-19 pandemic resulted in an appreciable number of hospitalized patients being admitted to intensive care units (ICUs) globally with a greater risk of HAIs. Consequently, a need to evaluate predictors and outcomes of HAIs among COVID-19 patients admitted to ICUs. A retrospective study of patients with COVID-19 admitted to the ICUs of three tertiary care hospi-tals in the Punjab province over a five-month period in 2021 was undertaken to ascertain pre-dictors and outcomes of HAIs. Of 4534 hospitalized COVID-19 patients, 678 were admitted to ICUs, of whom 636 patients fulfilled the inclusion criteria. Overall, 67 HAIs were identified among admitted patients. Ventilator-associated lower respiratory tract infections and catheter related urinary tract infections were the most frequent HAIs. A significantly higher number of patients who developed HAIs were on anticoagulants (p = 0.003), antithrombotic agents (p < 0.001), anti-virals (p < 0.001) and IL-6 inhibiting agents (p < 0.001). Secondary infections were significantly higher in patients who were on invasive mechanical ventilation (p < 0.001), had central venous access (p = 0.023), and urinary catheters (p < 0.001). The mortality rate was significantly higher in those with secondary infections (25.8% vs 1.2%, p < 0.001). Our study concluded that COVID-19 patients admitted to ICU have a high prevalence of HAIs associated with greater mortality. Key factors need to be addressed to reduce HAIs.

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