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The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19
BACKGROUND: The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVI...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576217/ https://www.ncbi.nlm.nih.gov/pubmed/36283138 http://dx.doi.org/10.1016/j.clinsp.2022.100130 |
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author | de Macedo, Viviane dos Santos, Gabriela de Souza da Silva, Rodolff Nunes Couto, Caio Nogara de Menezes Bastos, Camila Viecelli, Eloize Mateus, Marina do Nascimento Graf, Maria Esther Gonçalves, Raquel Bernardelli da Silva, Márcia Aparecida Bernardini, Patricia Dal Bem Grando, Roberta Serra Pereira Boaventura, Viviane Pavanelo Pereira, Helki Simone Rodrigues Levin, Anna S. |
author_facet | de Macedo, Viviane dos Santos, Gabriela de Souza da Silva, Rodolff Nunes Couto, Caio Nogara de Menezes Bastos, Camila Viecelli, Eloize Mateus, Marina do Nascimento Graf, Maria Esther Gonçalves, Raquel Bernardelli da Silva, Márcia Aparecida Bernardini, Patricia Dal Bem Grando, Roberta Serra Pereira Boaventura, Viviane Pavanelo Pereira, Helki Simone Rodrigues Levin, Anna S. |
author_sort | de Macedo, Viviane |
collection | PubMed |
description | BACKGROUND: The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU). METHODS: This is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done. RESULTS: Sixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009). CONCLUSIONS: Male gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential. |
format | Online Article Text |
id | pubmed-9576217 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-95762172022-10-18 The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 de Macedo, Viviane dos Santos, Gabriela de Souza da Silva, Rodolff Nunes Couto, Caio Nogara de Menezes Bastos, Camila Viecelli, Eloize Mateus, Marina do Nascimento Graf, Maria Esther Gonçalves, Raquel Bernardelli da Silva, Márcia Aparecida Bernardini, Patricia Dal Bem Grando, Roberta Serra Pereira Boaventura, Viviane Pavanelo Pereira, Helki Simone Rodrigues Levin, Anna S. Clinics (Sao Paulo) Original Articles BACKGROUND: The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU). METHODS: This is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done. RESULTS: Sixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009). CONCLUSIONS: Male gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential. Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo 2022-10-17 /pmc/articles/PMC9576217/ /pubmed/36283138 http://dx.doi.org/10.1016/j.clinsp.2022.100130 Text en © 2022 HCFMUSP. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Articles de Macedo, Viviane dos Santos, Gabriela de Souza da Silva, Rodolff Nunes Couto, Caio Nogara de Menezes Bastos, Camila Viecelli, Eloize Mateus, Marina do Nascimento Graf, Maria Esther Gonçalves, Raquel Bernardelli da Silva, Márcia Aparecida Bernardini, Patricia Dal Bem Grando, Roberta Serra Pereira Boaventura, Viviane Pavanelo Pereira, Helki Simone Rodrigues Levin, Anna S. The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title | The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title_full | The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title_fullStr | The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title_full_unstemmed | The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title_short | The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19 |
title_sort | health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with covid-19 |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576217/ https://www.ncbi.nlm.nih.gov/pubmed/36283138 http://dx.doi.org/10.1016/j.clinsp.2022.100130 |
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