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Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs

Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric...

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Autores principales: Fresán-Ruiz, Elena, Pons-Tomás, Gemma, de Carlos-Vicente, Juan Carlos, Bustinza-Arriortua, Amaya, Slocker-Barrio, María, Belda-Hofheinz, Sylvia, Nieto-Moro, Montserrat, Uriona-Tuma, Sonia María, Pinós-Tella, Laia, Morteruel-Arizcuren, Elvira, Schuffelmann, Cristina, Peña-López, Yolanda, Bobillo-Pérez, Sara, Jordan, Iolanda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688919/
https://www.ncbi.nlm.nih.gov/pubmed/36360398
http://dx.doi.org/10.3390/children9111669
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author Fresán-Ruiz, Elena
Pons-Tomás, Gemma
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
author_facet Fresán-Ruiz, Elena
Pons-Tomás, Gemma
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
author_sort Fresán-Ruiz, Elena
collection PubMed
description Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric intensive care units (PICUs) over a 3-month period each year from 2014 to 2019. To make comparisons and evaluate the influence of HAI Zero Bundles (care bundles that intend to reduce the DA-HAI rates to zero) on PICU HAI rates, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once most of the units had incorporated all the Zero Bundles). A total of 11,260 pediatric patients were included. There were 390 episodes of HAIs in 317 patients and the overall rate of HAIs was 6.3 per 1000 patient days. The DA-HAI distribution was: 2.46/1000 CVC days for central-line-associated bloodstream infections (CLABSIs), 5.75/1000 MV days for ventilator-associated pneumonia (VAP) and 3.6/1000 UC days for catheter-associated urinary tract infections (CAUTIs). Comparing the two periods, the HAI rate decreased (p = 0.061) as well as HAI episodes (p = 0.011). The results demonstrate that exposure to devices constitutes an extrinsic risk factor for acquiring HAIs. The multivariate analysis highlights previous bacterial colonization by multidrug-resistant (MDR) bacteria as the most important extrinsic risk factor for HAIs (OR 20.4; 95%CI 14.3–29.1). In conclusion, HAI Zero Bundles have been shown to decrease HAI rates, and the focus should be on the prompt removal of devices, especially in children with important intrinsic risk factors.
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spelling pubmed-96889192022-11-25 Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs Fresán-Ruiz, Elena Pons-Tomás, Gemma de Carlos-Vicente, Juan Carlos Bustinza-Arriortua, Amaya Slocker-Barrio, María Belda-Hofheinz, Sylvia Nieto-Moro, Montserrat Uriona-Tuma, Sonia María Pinós-Tella, Laia Morteruel-Arizcuren, Elvira Schuffelmann, Cristina Peña-López, Yolanda Bobillo-Pérez, Sara Jordan, Iolanda Children (Basel) Article Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric intensive care units (PICUs) over a 3-month period each year from 2014 to 2019. To make comparisons and evaluate the influence of HAI Zero Bundles (care bundles that intend to reduce the DA-HAI rates to zero) on PICU HAI rates, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once most of the units had incorporated all the Zero Bundles). A total of 11,260 pediatric patients were included. There were 390 episodes of HAIs in 317 patients and the overall rate of HAIs was 6.3 per 1000 patient days. The DA-HAI distribution was: 2.46/1000 CVC days for central-line-associated bloodstream infections (CLABSIs), 5.75/1000 MV days for ventilator-associated pneumonia (VAP) and 3.6/1000 UC days for catheter-associated urinary tract infections (CAUTIs). Comparing the two periods, the HAI rate decreased (p = 0.061) as well as HAI episodes (p = 0.011). The results demonstrate that exposure to devices constitutes an extrinsic risk factor for acquiring HAIs. The multivariate analysis highlights previous bacterial colonization by multidrug-resistant (MDR) bacteria as the most important extrinsic risk factor for HAIs (OR 20.4; 95%CI 14.3–29.1). In conclusion, HAI Zero Bundles have been shown to decrease HAI rates, and the focus should be on the prompt removal of devices, especially in children with important intrinsic risk factors. MDPI 2022-10-31 /pmc/articles/PMC9688919/ /pubmed/36360398 http://dx.doi.org/10.3390/children9111669 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fresán-Ruiz, Elena
Pons-Tomás, Gemma
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title_full Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title_fullStr Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title_full_unstemmed Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title_short Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
title_sort device exposure and patient risk factors’ impact on the healthcare-associated infection rates in picus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688919/
https://www.ncbi.nlm.nih.gov/pubmed/36360398
http://dx.doi.org/10.3390/children9111669
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