RESUMO
Healthcare-associated infections (HAIs) present a global public health challenge, contributing to high morbidity and mortality and substantial economic burdens. Ventilator-associated pneumonia (VAP) ranks as the second most prevalent HAI in intensive care units (ICUs), emphasizing the need for economic analyses in this context. This retrospective cohort study, conducted at the General Hospital of Alicante from 2012 to 2019, aimed to assess additional costs related to VAP by comparing the extended length of stay for infected and non-infected ICU patients undergoing mechanical ventilation (MV) for more than 48 h. Employing propensity score association, 434 VAP patients were compared to an equal number without VAP. The findings indicate a significantly longer mechanical ventilation period for VAP patients (17.40 vs. 8.93 days, p < 0.001), resulting in an extra 13.56 days of stay and an additional cost of EUR 20,965.28 per VAP episode. The study estimated a total cost of EUR 12,348,965.28 for VAP during the study period, underscoring the economic impact of VAP. These findings underscore the urgent need for rigorous infection surveillance, prevention, and control measures to enhance healthcare quality and reduce overall expenditures.
RESUMO
BACKGROUND: Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. OBJECTIVE: The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. METHODS: We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. RESULTS: Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non-work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was -0.014 (95% confidence interval, -0.020 to -0.009). CONCLUSIONS: A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.