Clinical and microbiological profile of health care-associated infections in a tertiary hospital: Comparison between a cohort of hospitalized patients during prepandemic and COVID-19 pandemic periods

Am J Infect Control. 2024 Jun;52(6):712-718. doi: 10.1016/j.ajic.2023.12.018. Epub 2024 Jan 3.

Abstract

Background: During the COVID-19 pandemic, health service practices underwent significant changes, impacting the occurrence of health care-associated infections (HAIs). This study presents the epidemiology of bacterial infections and compares clinical data on nosocomial infections in hospitalized patients before and during the pandemic.

Methods: A unicentric, observational, retrospective cohort study was conducted with descriptive analyses on the microorganism identification and resistance profile. Patient's clinical data who had hospital-acquired infection (HAI), during their hospitalization in a tertiary hospital before and during the COVID-19 pandemic was compared by descriptive and inferential analyses.

Results: A total of 1,581 bacteria were isolated from 1,183 hospitalized patients. Among patients coinfected with COVID-19, there was a statistically significant increase in HAI-related deaths (P < .001) and HAI caused by multidrug-resistant organisms (P < .001), mainly by Acinetobacter baumannii and Staphylococcus aureus. A higher odds ratio of HAI-related deaths compared to the prepandemic period was observed (odds ratio 6.98 [95% confidence interval 3.97-12.64]).

Conclusions: The higher incidence of multidrug-resistant bacteria and increased deaths due to HAI, especially in patients with COVID-19 coinfection, might be related to various factors such as increased workload, broad-spectrum antibiotic use, and limited resources. The pandemic has changed the profile of circulating bacteria and antimicrobial resistance. Prevention strategies should be considered to reduce the impact of these infections.

Keywords: Health care-related infections; Methicilin-resistant S aureus; Morbidity; Mortality; Multidrug resistant infection.

Publication types

  • Observational Study
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Bacterial Infections / epidemiology
  • Bacterial Infections / microbiology
  • COVID-19* / epidemiology
  • Cohort Studies
  • Cross Infection* / epidemiology
  • Cross Infection* / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Tertiary Care Centers* / statistics & numerical data