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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9688919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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