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
; 77: 100130, 2022. tab
Artigo
em Inglês
|
LILACS-Express
| ID: biblio-1421232
Abstract 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.
Biblioteca responsável:
BR1.1
Texto completo