Healthcare-associated infections in an intensive care unit: a descriptive study, Mato Grosso state, Brazil, 2018-2021Objective To analyze the demographic and microbiological characteristics and clinical outcomes of people with healthcare-associated infections (HAI) admitted to an intensive care unit (ICU) in Mato Grosso state, Brazil, between 2018 and 2021, comparing the pre-COVID-19 and the COVID-19 pandemic periods.
Methods This is a descriptive and longitudinal study with secondary data on people diagnosed with HAI. HAI, isolated microorganisms, sensitivity profile, comorbidities, clinical outcomes and sociodemographic data were analyzed.
Results Between 2018 and 2021, 384 people were admitted to the ICU. There were 218 HAI episodes in 179 of them. In the pre-pandemic period (2018-2019), 95 episodes were recorded in 73 people, predominantly associated with: mechanical ventilation (48.4%), male sex (65.8%), the 40-64 age group (43.8%), those of mixed race (80.8%) and hypertensive (45.2%), with 19.2% recovery and 79.4% death. During the pandemic period (2020-2021), 123 episodes occurred in 106 people, with a predominance of primary bloodstream infection (43.1%) in females (50.9%), in the 17-39 age group (40.6%), those of mixed race (65.1%), and with hypertension (35.8%), with a 62.3% cure rate and a 37.7% death rate. There was persistently high overall carbapenem resistance in both periods. Between 2018 and 2019, Klebsiella pneumoniae (81.2%) and Acinetobacter spp. (78.6%) predominated. Between 2020 and 2021, resistance was found for Klebsiella pneumoniae (73.9%) and Acinetobacter spp. (80.0%).
Conclusion HAI in the ICU remained severe and associated with persistent antimicrobial resistance, mainly to multidrug-resistant Klebsiella pneumoniae. This emphasized the urgency of more effective prevention and control strategies in the hospital setting.
Keywords
Intensive Care Units; Hospital Infection Control Services; Drug Resistance, Microbial; COVID-19; Retrospective Studies