Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients

BackgroundHealthcare-associate infection (HAI) has been one of the health care issues worldwide. During the COVID-19 pandemic, HAI prevention was considered a vital aspect of the clinical management of COVID-19. In the present study, we aimed to compare the frequency of HAIs in ICU-admitted cases wi...

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Main Authors: Armin Khavandegar, Zeinab Siami, Aziz Rasouli, Pershang Nazemi, Anoosha Gull
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475221/full
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author Armin Khavandegar
Zeinab Siami
Aziz Rasouli
Pershang Nazemi
Anoosha Gull
author_facet Armin Khavandegar
Zeinab Siami
Aziz Rasouli
Pershang Nazemi
Anoosha Gull
author_sort Armin Khavandegar
collection DOAJ
description BackgroundHealthcare-associate infection (HAI) has been one of the health care issues worldwide. During the COVID-19 pandemic, HAI prevention was considered a vital aspect of the clinical management of COVID-19. In the present study, we aimed to compare the frequency of HAIs in ICU-admitted cases within and before the COVID-19 era.MethodsThis multicenter retrospective study applied a descriptive-analytical approach to investigate the frequency of HAIs in the ICU departments of hospitals affiliated with Tehran University of Medical Sciences from 2017 to 2022.ResultsOverall, 14,268 cases with 20,942 isolated microorganisms were recruited for this study, with 8,289 (58.1%) of them being male and 5,975 (41.9%) being female. A total of 6,722 (47.1%) cases with 9,917 (47.4%) isolated microorganisms were documented in the pre-COVID-19 era, while 7,546 (52.9%) patients with 11,025 (52.64%) were reported in COVID-19 era. Of 14,268 patients admitted to the ICU during the study period, 9,197 (64.8%) were discharged and 5,071 died (35.5%), of which 1,970 (29.3%) occurred in pre-COVID and 4,752 (70.7%) in the COVID-19 era (p-value < 0.001). Klebsiella species, Acinetobacter species, Escherichia coli, Staphylococcus species, and Pseudomonas aeruginosa were the five most frequent isolated microorganisms, reported in 5,542 (26.50%), 4,171 (19.90%), 2,651 (12.70%), 2,537 (12.10%), and 1,851 (8.80%) cultures, respectively. VAEs were the most common infection types as reported in 3,562 (25%) patients. There was a statistically significant difference in UTI, PMEU, BSI, and others, with an increase in PMEUs (13.5% vs. 17.1%) and BSI (22.7% vs. 24.5%) and a decrease in UTIs (24.5% vs. 22.2%) and others (4.2% vs. 2.6%) in COVID-19 era compared to pre-COVID-19. The odds of in-hospital mortality in all six main infection categories have significantly increased in the COVID-19 era when compared to the pre-COVID-19 era. The odds of death were increased in the SSI group more than the rest (OR:2.65, CI 95%: 2.13–3.29).ConclusionCOVID-19 changed the pattern of HAIs and also increased their mortality. Overall, the findings of this study emphasize the importance of continuous monitoring and improvement of infection control measures in ICUs to reduce the incidence of HAIs and improve patient outcomes.
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spelling doaj-art-2cfb3c9dffd3457a849d53879210ead52025-02-07T06:49:41ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.14752211475221Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patientsArmin Khavandegar0Zeinab Siami1Aziz Rasouli2Pershang Nazemi3Anoosha Gull4Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IranDepartment of Infectious Disease and Tropical Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Emergency Medicine, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, IranInfectious Diseases Department, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, IranStudent Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, IranBackgroundHealthcare-associate infection (HAI) has been one of the health care issues worldwide. During the COVID-19 pandemic, HAI prevention was considered a vital aspect of the clinical management of COVID-19. In the present study, we aimed to compare the frequency of HAIs in ICU-admitted cases within and before the COVID-19 era.MethodsThis multicenter retrospective study applied a descriptive-analytical approach to investigate the frequency of HAIs in the ICU departments of hospitals affiliated with Tehran University of Medical Sciences from 2017 to 2022.ResultsOverall, 14,268 cases with 20,942 isolated microorganisms were recruited for this study, with 8,289 (58.1%) of them being male and 5,975 (41.9%) being female. A total of 6,722 (47.1%) cases with 9,917 (47.4%) isolated microorganisms were documented in the pre-COVID-19 era, while 7,546 (52.9%) patients with 11,025 (52.64%) were reported in COVID-19 era. Of 14,268 patients admitted to the ICU during the study period, 9,197 (64.8%) were discharged and 5,071 died (35.5%), of which 1,970 (29.3%) occurred in pre-COVID and 4,752 (70.7%) in the COVID-19 era (p-value < 0.001). Klebsiella species, Acinetobacter species, Escherichia coli, Staphylococcus species, and Pseudomonas aeruginosa were the five most frequent isolated microorganisms, reported in 5,542 (26.50%), 4,171 (19.90%), 2,651 (12.70%), 2,537 (12.10%), and 1,851 (8.80%) cultures, respectively. VAEs were the most common infection types as reported in 3,562 (25%) patients. There was a statistically significant difference in UTI, PMEU, BSI, and others, with an increase in PMEUs (13.5% vs. 17.1%) and BSI (22.7% vs. 24.5%) and a decrease in UTIs (24.5% vs. 22.2%) and others (4.2% vs. 2.6%) in COVID-19 era compared to pre-COVID-19. The odds of in-hospital mortality in all six main infection categories have significantly increased in the COVID-19 era when compared to the pre-COVID-19 era. The odds of death were increased in the SSI group more than the rest (OR:2.65, CI 95%: 2.13–3.29).ConclusionCOVID-19 changed the pattern of HAIs and also increased their mortality. Overall, the findings of this study emphasize the importance of continuous monitoring and improvement of infection control measures in ICUs to reduce the incidence of HAIs and improve patient outcomes.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475221/fullintensive care unit (ICU)healthcare-associated infection (HAI)nosocomial infectioninfection prevention and control (IPC)coronavirus disease 2019 (COVID-19)pandemic-related infections
spellingShingle Armin Khavandegar
Zeinab Siami
Aziz Rasouli
Pershang Nazemi
Anoosha Gull
Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
Frontiers in Public Health
intensive care unit (ICU)
healthcare-associated infection (HAI)
nosocomial infection
infection prevention and control (IPC)
coronavirus disease 2019 (COVID-19)
pandemic-related infections
title Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
title_full Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
title_fullStr Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
title_full_unstemmed Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
title_short Impact of healthcare-associated infections on in-hospital outcomes during the COVID-19 era: a multicenter comparative study of 20,942 isolated microorganisms from ICU patients
title_sort impact of healthcare associated infections on in hospital outcomes during the covid 19 era a multicenter comparative study of 20 942 isolated microorganisms from icu patients
topic intensive care unit (ICU)
healthcare-associated infection (HAI)
nosocomial infection
infection prevention and control (IPC)
coronavirus disease 2019 (COVID-19)
pandemic-related infections
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475221/full
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