Yoğun Bakım Ünitesinde Takip Edilen Hastalarda SARS-CoV-2 Pozitifliğinin Nozokomiyal İnfeksiyon Gelişmesine Etkileri: Retrospektif Çalışma


Ünal G., Türe Yüce Z., Kalın Ünüvar G., Karayol Akın A., Çoruh A., Ülgey A., ...More

FLORA INFEKSIYON HASTALIKLARI VE KLINIK MIKROBIYOLOJI DERGISI, vol.28, no.2, pp.144-155, 2023 (ESCI) identifier identifier

Abstract

Introduction: Nosocomial infections (NI) increase morbidity and mortality in patients in the COVID-19 ICU. In this study, it was aimed to determine the risk factors for nosocomial infections in patients treated in the COVID-19 ICU.Materials and Methods: Patients who were treated in the COVID-19 and non-COVID-19 ICU between March 2020 and June 2021 were analyzed retrospectively. Demographic data, chronic diseases, invasive procedures and risk factors were compared between patients with and without NI.Results: The study included 174 patients, and 84 from COVID-19 ICU. The median age of the patients was 66.5 (21-92) and the male gender rate was 56.9%. The frequency of hospitalization in the last three months and the mean Charlson comorbidity index were higher in patients treated in the COVID-19 ICU (p= 0.001). Presence of any nosocomial infection (64% vs 46%), rate of nosocomial pneumonia (10.7% vs. 2.2%), and catheter-related bloodstream infection rate were higher in the COVID-19 ICU. The 14-day mortality rates were 57% in the COVID-19 ICU, while it was 33% in the non-COVID-19 ICU (p=0.002). Advanced age [OR=0.97 (95% CI= 0.94-1.0) p= 0.049], prolonged stay in the ICU [OR= 1.28 (95% CI= 1.16-1.41) p=0.001], chronic kidney disease [OR= 10.57 (95% CI= 2.02-54.56) p= 0.05], and coronary artery disease [OR= 4.61 (95% CI= 1.44-14.79) p= 0.010] were found to be risk factors for NI, while other risk factors were enteral nutrition [OR= 2.69 (95% CI= 1.03-7.04) p= 0.043], central catheter [OR= 4.60 (95% CI= 1.88-11.22) p= 0.001] and a history of hospitalization in the ICU in the last three months [OR= 3.59 (95% CI= 1.01-12.83) p= 0.048]. Risk factors for NI in the COVID-19 ICU include prolonged ICU stay and enteral nutrition. Conclusion: The presence of COVID-19 in patients treated in the ICU is important . Long-term ICU follow-up, invasive procedures and enteral nutrition practices are important risk factors for the development of NI in patients with a diagnosis of COVID-19.