PDF(Pubmed)
Abstract：
BACKGROUND: This study examines the impact of the COVID-19 pandemic on health care-associated infection (HAI) incidence in low- and middle-income countries (LMICs).
METHODS: Patients from 7 LMICs were followed up during hospital intensive care unit (ICU) stays from January 2019 to May 2020. HAI rates were calculated using the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System applying the Centers for Disease Control and Prevention\'s National Healthcare Safety Network (CDC-NHSN) criteria. Pre-COVID-19 rates for 2019 were compared with COVID-19 era rates for 2020 for central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), mortality, and length of stay (LOS).
RESULTS: A total of 7,775 patients were followed up for 49,506 bed days. The 2019 to 2020 rate comparisons were 2.54 and 4.73 CLABSIs per 1,000 central line days (risk ratio [RR] = 1.85, p = .0006), 9.71 and 12.58 VAEs per 1,000 mechanical ventilator days (RR = 1.29, p = .10), and 1.64 and 1.43 CAUTIs per 1,000 urinary catheter days (RR = 1.14; p = .69). Mortality rates were 15.2% and 23.2% for 2019 and 2020 (RR = 1.42; p < .0001), respectively. Mean LOS for 2019 and 2020 were 6.02 and 7.54 days (RR = 1.21, p < .0001), respectively.
CONCLUSIONS: This study documents an increase in HAI rates in 7 LMICs during the first 5 months of the COVID-19 pandemic and highlights the need to reprioritize and return to conventional infection prevention practices.
METHODS: Patients from 7 LMICs were followed up during hospital intensive care unit (ICU) stays from January 2019 to May 2020. HAI rates were calculated using the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System applying the Centers for Disease Control and Prevention\'s National Healthcare Safety Network (CDC-NHSN) criteria. Pre-COVID-19 rates for 2019 were compared with COVID-19 era rates for 2020 for central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), mortality, and length of stay (LOS).
RESULTS: A total of 7,775 patients were followed up for 49,506 bed days. The 2019 to 2020 rate comparisons were 2.54 and 4.73 CLABSIs per 1,000 central line days (risk ratio [RR] = 1.85, p = .0006), 9.71 and 12.58 VAEs per 1,000 mechanical ventilator days (RR = 1.29, p = .10), and 1.64 and 1.43 CAUTIs per 1,000 urinary catheter days (RR = 1.14; p = .69). Mortality rates were 15.2% and 23.2% for 2019 and 2020 (RR = 1.42; p < .0001), respectively. Mean LOS for 2019 and 2020 were 6.02 and 7.54 days (RR = 1.21, p < .0001), respectively.
CONCLUSIONS: This study documents an increase in HAI rates in 7 LMICs during the first 5 months of the COVID-19 pandemic and highlights the need to reprioritize and return to conventional infection prevention practices.
摘要：
背景：这项研究调查了COVID-19大流行对低收入和中等收入国家（LMICs）医疗保健相关感染（HAI）发病率的影响。
方法：在2019年1月至2020年5月的重症监护病房（ICU）期间，对来自7个LMIC的患者进行了随访。使用国际医院感染控制协会（INICC）在线监测系统，应用疾病控制和预防中心的国家医疗保健安全网络（CDC-NHSN）标准计算HAI率。将2019年的COVID-19前期率与2020年的COVID-19时代的中心线路相关血流感染（CLABSI）率进行了比较，导管相关尿路感染（CAUTIs），呼吸机相关事件（VAE），死亡率,和停留时间（LOS）。
结果：共有7,775例患者获得随访，随访时间为49,506天。2019年至2020年的费率比较为每1000个中线日2.54和4.73个CLABSI（风险比[RR]=1.85，p=.0006），每1,000个机械呼吸机日9.71和12.58个VAE（RR=1.29，p=.10），和1.64和1.43CAUTI每1,000导尿管天（RR=1.14;p=.69）。2019年和2020年的死亡率分别为15.2%和23.2%（RR=1.42；p<0.0001），分别。2019年和2020年的平均LOS分别为6.02天和7.54天（RR=1.21，p<0.0001），分别。
结论：这项研究记录了在COVID-19大流行的前5个月中，7个低收入国家的HAI发病率上升，并强调需要重新确定优先次序并恢复传统的感染预防措施。
方法：在2019年1月至2020年5月的重症监护病房（ICU）期间，对来自7个LMIC的患者进行了随访。使用国际医院感染控制协会（INICC）在线监测系统，应用疾病控制和预防中心的国家医疗保健安全网络（CDC-NHSN）标准计算HAI率。将2019年的COVID-19前期率与2020年的COVID-19时代的中心线路相关血流感染（CLABSI）率进行了比较，导管相关尿路感染（CAUTIs），呼吸机相关事件（VAE），死亡率,和停留时间（LOS）。
结果：共有7,775例患者获得随访，随访时间为49,506天。2019年至2020年的费率比较为每1000个中线日2.54和4.73个CLABSI（风险比[RR]=1.85，p=.0006），每1,000个机械呼吸机日9.71和12.58个VAE（RR=1.29，p=.10），和1.64和1.43CAUTI每1,000导尿管天（RR=1.14;p=.69）。2019年和2020年的死亡率分别为15.2%和23.2%（RR=1.42；p<0.0001），分别。2019年和2020年的平均LOS分别为6.02天和7.54天（RR=1.21，p<0.0001），分别。
结论：这项研究记录了在COVID-19大流行的前5个月中，7个低收入国家的HAI发病率上升，并强调需要重新确定优先次序并恢复传统的感染预防措施。
