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
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 outco...
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| Veröffentlicht in: | The Journal of hospital infection 2023-10, Vol.140, p.124-131 |
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| creator | Barchitta, M. Maugeri, A. Favara, G. Lio, R. Magnano San 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. 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. |
| description | 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 |
| doi_str_mv | 10.1016/j.jhin.2023.07.021 |
| format | Article |
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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.</description><identifier>ISSN: 0195-6701</identifier><identifier>ISSN: 1532-2939</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2023.07.021</identifier><identifier>PMID: 37562591</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>COVID-19 ; COVID-19 - epidemiology ; Cross Infection - epidemiology ; Delivery of Health Care ; Healthcare-associated infections ; Humans ; Incidence ; Intensive care unit ; Intensive Care Units ; Italy - epidemiology ; Nosocomial infections ; Pandemic ; Pandemics ; SARS-CoV-2</subject><ispartof>The Journal of hospital infection, 2023-10, Vol.140, p.124-131</ispartof><rights>2023 The Authors</rights><rights>Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-e6b07c79ec3c2317b1aaab5a01d1298f0264531822840f1dbbbc117500bc30913</citedby><cites>FETCH-LOGICAL-c449t-e6b07c79ec3c2317b1aaab5a01d1298f0264531822840f1dbbbc117500bc30913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhin.2023.07.021$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37562591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barchitta, M.</creatorcontrib><creatorcontrib>Maugeri, A.</creatorcontrib><creatorcontrib>Favara, G.</creatorcontrib><creatorcontrib>Lio, R. 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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.</description><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Cross Infection - epidemiology</subject><subject>Delivery of Health Care</subject><subject>Healthcare-associated infections</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive care unit</subject><subject>Intensive Care Units</subject><subject>Italy - epidemiology</subject><subject>Nosocomial infections</subject><subject>Pandemic</subject><subject>Pandemics</subject><subject>SARS-CoV-2</subject><issn>0195-6701</issn><issn>1532-2939</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQhy0EotvCC3BAPnJJmLHzF3FBC5RIFUViy9VynAnrKOsU21vUN-FxcdjCEcnSSKNvPnv8Y-wFQo6A1espn_bW5QKEzKHOQeAjtsFSiky0sn3MNoBtmVU14Bk7D2ECgNQvn7IzWZeVKFvcsF-7PXHrIvn40zrrvvNl5HvSc9wb7SnTISzG6khDokYy0S4ucO0Gvr3-1r3PsE193kU9W-3-iFywd8TXYX50NoY3iU5Hz_fBhtUe041fv3Sfs5tdx2_9MiUrH_1y4AKg4nFJVeAz9mTUc6DnD_WC3Xz8sNt-yq6uL7vtu6vMFEUbM6p6qE3dkpFGSKx71Fr3pQYcULTNCKIqSomNEE0BIw593xvEugTojYQW5QV7dfKml_w4UojqYIOhedaOlmNQoilBomygSKg4ocYvIXga1a23B-3vFYJaE1GTWhNRayIKapXWSEMvH_zH_kDDv5G_ESTg7QmgtOWdJa-CseQMDdann1HDYv_n_w3RjJsi</recordid><startdate>202310</startdate><enddate>202310</enddate><creator>Barchitta, M.</creator><creator>Maugeri, A.</creator><creator>Favara, G.</creator><creator>Lio, R. 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Magnano San ; 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. ; 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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-e6b07c79ec3c2317b1aaab5a01d1298f0264531822840f1dbbbc117500bc30913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>Cross Infection - epidemiology</topic><topic>Delivery of Health Care</topic><topic>Healthcare-associated infections</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive care unit</topic><topic>Intensive Care Units</topic><topic>Italy - epidemiology</topic><topic>Nosocomial infections</topic><topic>Pandemic</topic><topic>Pandemics</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barchitta, M.</creatorcontrib><creatorcontrib>Maugeri, A.</creatorcontrib><creatorcontrib>Favara, G.</creatorcontrib><creatorcontrib>Lio, R. 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Magnano San</au><au>La Rosa, M.C.</au><au>D'Ancona, F.</au><au>Agodi, A.</au><au>Murgia, P.</au><au>Masia, M.D.</au><au>Mura, I.</au><au>Brusaferro, S.</au><au>Arnoldo, L.</au><au>Di Stefano, C.</au><au>Lucchese, F.</au><au>Lugano, M.</au><au>Tardivo, S.</au><au>Moretti, F.</au><au>Bernasconi, M.O.</au><au>Pappalardo, F.</au><au>Pasquarella, C.</au><au>Sicoli, E.</au><au>Montagna, M.T.</au><au>Caggiano, G.</au><au>De Giglio, O.</au><au>Fenaroli, S.</au><au>Squeri, R.</au><au>Cannavò, G.</au><au>Pulvirenti, A.</au><au>Catalano, S.</au><au>Mattaliano, A.R.</au><au>Castiglione, G.</au><au>Astuto, M.</au><au>La Camera, G.</au><au>Panascia, E.</au><au>Longhitano, A.M.</au><au>Scrofani, G.</au><au>Gallea, M.R.</au><au>Civello, P.</au><au>Milazzo, M.</au><au>Calamusa, G.</au><au>Giarratano, A.</au><au>Di Benedetto, A.</au><au>Rizzo, G.M.G.</au><au>Manta, G.</au><au>Angelone, C.</au><au>Mancuso, R.</au><au>Tetamo, R.</au><au>Mella, L.M.</au><au>Dei, I.</au><au>Pandiani, I.</au><au>Cannistrà, A.</au><au>Piotti, P.</au><au>Girardis, M.</au><au>Barbieri, A.</au><au>Borracino, S.</au><au>Palermo, R.</au><au>Di Stefano, D.</au><au>Colombo, A.</au><au>Romeo, A.</au><au>Minerva, M.</au><au>Fabiani, L.</au><au>Marinangeli, F.</au><au>D’Errico, M.M.</au><au>Donati, A.</au><au>Domizi, R.</au><au>Saglimbene, S.T.</au><au>Bianco, A.</au><au>Vittori, C.</au><au>Orsi, G.B.</au><au>Scibilia, M.</au><au>Calà, O.</au><au>Di Giacinto, I.</au><au>Amatucci, M.R.</au><au>Principi, T.</au><au>Di Fabio, G.</au><au>Gobbini, V.</au><au>Olori, M.P.</au><au>Antonelli, M.</au><au>Laurenti, P.</au><au>Condorelli, L.</au><au>Ingala, F.</au><au>Russo, S.</au><au>Costa, P.</au><au>Canonico, L.</au><au>Farruggia, P.</au><au>Cristina, M.L.</au><au>Sartini, M.</au><au>Arrigoni, C.</au><au>Galassi, I.</au><au>Vinci, V.M.</au><aucorp>SPIN-UTI network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>The Journal of hospital infection</jtitle><addtitle>J Hosp Infect</addtitle><date>2023-10</date><risdate>2023</risdate><volume>140</volume><spage>124</spage><epage>131</epage><pages>124-131</pages><issn>0195-6701</issn><issn>1532-2939</issn><eissn>1532-2939</eissn><abstract>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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37562591</pmid><doi>10.1016/j.jhin.2023.07.021</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-6701 |
| ispartof | The Journal of hospital infection, 2023-10, Vol.140, p.124-131 |
| issn | 0195-6701 1532-2939 1532-2939 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2850313804 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | COVID-19 COVID-19 - epidemiology Cross Infection - epidemiology Delivery of Health Care Healthcare-associated infections Humans Incidence Intensive care unit Intensive Care Units Italy - epidemiology Nosocomial infections Pandemic Pandemics SARS-CoV-2 |
| title | 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 |
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