Aleksa Despotovic1, Branko Milosevic2, Ivana Milosevic3, Nikola Mitrovic2, Andja Cirkovic4, Snezana Jovanovic5, Goran Stevanovic6. 1. School of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: alexadespotovic21@gmail.com. 2. Department of Intensive Care, School of Medicine, University of Belgrade, Belgrade, Serbia; University Teaching Hospital for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia. 3. University Teaching Hospital for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia; Department of Hepatitis, School of Medicine, University of Belgrade, Belgrade, Serbia. 4. Department of Medical Statistics, School of Medicine, University of Belgrade, Belgrade, Serbia. 5. Department of Microbiology, Clinical Center of Serbia, Belgrade, Serbia. 6. University Teaching Hospital for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia; Department of Clinical Pharmacotherapy, School of Medicine, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND: Acquisition of Hospital-acquired infections (HAIs) in intensive care units (ICUs) predispose patients to higher mortality rates and additional adverse events. Serbian adult ICUs are rarely investigated for HAIs. The aim of this study was to look into HAIs in an adult ICU and identify risk factors for acquisition of HAIs and mortality. METHODS: This retrospective study included 355 patients hospitalized over a 2-year period. Patient characteristics, antimicrobial resistance patterns, and risk factors of acquisition and predictors of mortality in patients who had a HAI were examined. RESULTS: HAIs were diagnosed in 32.7% of patients. Resistance rates > 50% were observed in all antimicrobials except for tigecycline (14%), colistin (9%), and linezolid (0%). Predictors of HAI acquisition were underlying viral CNS infections and invasive devices-urinary and central venous catheters, and nasogastric tubes. Diabetes mellitus and intubation (odds ratio 2.5 and 6.7, P = .042 and <.001) were identified as predictors for increased mortality in patients who had a HAI. CONCLUSIONS: Prevalence of HAIs and resistance rates are high compared to ICUs in other European countries. Risk factors for both acquisition of HAI and mortality were identified. Large-scale studies are necessary to look at HAIs in adult ICUs in Serbia.
BACKGROUND: Acquisition of Hospital-acquired infections (HAIs) in intensive care units (ICUs) predispose patients to higher mortality rates and additional adverse events. Serbian adult ICUs are rarely investigated for HAIs. The aim of this study was to look into HAIs in an adult ICU and identify risk factors for acquisition of HAIs and mortality. METHODS: This retrospective study included 355 patients hospitalized over a 2-year period. Patient characteristics, antimicrobial resistance patterns, and risk factors of acquisition and predictors of mortality in patients who had a HAI were examined. RESULTS: HAIs were diagnosed in 32.7% of patients. Resistance rates > 50% were observed in all antimicrobials except for tigecycline (14%), colistin (9%), and linezolid (0%). Predictors of HAI acquisition were underlying viral CNS infections and invasive devices-urinary and central venous catheters, and nasogastric tubes. Diabetes mellitus and intubation (odds ratio 2.5 and 6.7, P = .042 and <.001) were identified as predictors for increased mortality in patients who had a HAI. CONCLUSIONS: Prevalence of HAIs and resistance rates are high compared to ICUs in other European countries. Risk factors for both acquisition of HAI and mortality were identified. Large-scale studies are necessary to look at HAIs in adult ICUs in Serbia.
Authors: J Marin-Corral; S Pascual-Guardia; R Muñoz-Bermúdez; A Salazar-Degracia; C Climent; C Vilà-Vilardell; M Acer; M Picornell; M I Restrepo; J R Masclans; F Álvarez-Lerma Journal: Med Intensiva (Engl Ed) Date: 2022-04
Authors: J Marin-Corral; S Pascual-Guardia; R Muñoz-Bermúdez; A Salazar-Degracia; C Climent; C Vilà-Vilardell; M Acer; M Picornell; M I Restrepo; J R Masclans; F Álvarez-Lerma Journal: Med Intensiva Date: 2021-04-30 Impact factor: 2.491
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