The intertwining of healthcare-associated infections and COVID-19 in Italian intensive care units: an analysis of the SPIN-UTI project from 2006 to 2021
- Creators
- Barchitta, M.
- Maugeri, A.
- Favara, G.
- Lio, R. Magnano San
- La Rosa, M. C.
- D'Ancona, F.
- Agodi, A.
- Murgia, P.
- Masia, M. D.
- Mura, I.
- Brusaferro, S.
- Arnoldo, L.
- Di Stefano, C.
- Lucchese, F.
- Lugano, M.
- Tardivo, S.
- Moretti, F.
- Bernasconi, M. O.
- Pappalardo, F.
- Pasquarella, C.
- Sicoli, E.
- Montagna, M. T.
- Caggiano, G.
- De Giglio, O.
- Fenaroli, S.
- Squeri, R.
- Cannavò, G.
- Pulvirenti, A.
- Catalano, S.
- Mattaliano, A. R.
- Castiglione, G.
- Astuto, M.
- La Camera, G.
- Panascia, E.
- Longhitano, A. M.
- Scrofani, G.
- Gallea, M. R.
- Civello, P.
- Milazzo, M.
- Calamusa, G.
- Giarratano, A.
- Di Benedetto, A.
- Rizzo, G. M. G.
- Manta, G.
- Angelone, C.
- Mancuso, R.
- Tetamo, R.
- Mella, L. M.
- Dei, I.
- Pandiani, I.
- Cannistrà, A.
- Piotti, P.
- Girardis, M.
- Barbieri, A.
- Borracino, S.
- Palermo, R.
- Di Stefano, D.
- Colombo, A.
- Romeo, A.
- Minerva, M.
- Fabiani, L.
- Marinangeli, F.
- D'Errico, M. M.
- Donati, A.
- Domizi, R.
- Saglimbene, S. T.
- Bianco, A.
- Vittori, C.
- Orsi, G. B.
- Scibilia, M.
- Calà, O.
- Giacinto, I.
- Amatucci, M. R.
- Principi, T.
- Di Fabio, G.
- Gobbini, V.
- Olori, M. P.
- Antonelli, M.
- Laurenti, P.
- Condorelli, L.
- Ingala, F.
- Russo, S.
- Costa, P.
- Canonico, L.
- Farruggia, P.
- Cristina, M. L.
- Sartini, M.
- Arrigoni, C.
- Galassi, I.
- Vinci, V. M.
- Others:
- Barchitta, M.
- Maugeri, A.
- Favara, G.
- Lio, R. Magnano San
- La Rosa, M. C.
- D'Ancona, F.
- Agodi, A.
- Murgia, P.
- Masia, M. D.
- Mura, I.
- Brusaferro, S.
- Arnoldo, L.
- Di Stefano, C.
- Lucchese, F.
- Lugano, M.
- Tardivo, S.
- Moretti, F.
- Bernasconi, M. O.
- Pappalardo, F.
- Pasquarella, C.
- Sicoli, E.
- Montagna, M. T.
- Caggiano, G.
- De Giglio, O.
- Fenaroli, S.
- Squeri, R.
- Cannavò, G.
- Pulvirenti, A.
- Catalano, S.
- Mattaliano, A. R.
- Castiglione, G.
- Astuto, M.
- La Camera, G.
- Panascia, E.
- Longhitano, A. M.
- Scrofani, G.
- Gallea, M. R.
- Civello, P.
- Milazzo, M.
- Calamusa, G.
- Giarratano, A.
- Di Benedetto, A.
- Rizzo, G. M. G.
- Manta, G.
- Angelone, C.
- Mancuso, R.
- Tetamo, R.
- Mella, L. M.
- Dei, I.
- Pandiani, I.
- Cannistrà, A.
- Piotti, P.
- Girardis, M.
- Barbieri, A.
- Borracino, S.
- Palermo, R.
- Di Stefano, D.
- Colombo, A.
- Romeo, A.
- Minerva, M.
- Fabiani, L.
- Marinangeli, F.
- D'Errico, M. M.
- Donati, A.
- Domizi, R.
- Saglimbene, S. T.
- Bianco, A.
- Vittori, C.
- Orsi, G. B.
- Scibilia, M.
- Calà, O.
- Giacinto, I.
- Amatucci, M. R.
- Principi, T.
- Di Fabio, G.
- Gobbini, V.
- Olori, M. P.
- Antonelli, M.
- Laurenti, P.
- Condorelli, L.
- Ingala, F.
- Russo, S.
- Costa, P.
- Canonico, L.
- Farruggia, P.
- Cristina, M. L.
- Sartini, M.
- Arrigoni, C.
- Galassi, I.
- Vinci, V. M.
Description
Background: Although healthcare-associated infections (HAIs) pose an extraordinary burden on public health, the impact of coronavirus disease 2019 (COVID-19) is still a matter of debate. Aim: To describe trends of HAIs in Italian intensive care units (ICUs) from 2006 to 2021, and to compare characteristics and outcomes of patients with or without COVID-19. Methods: We evaluated patients participating in the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' (SPIN-UTI) project, who were admitted to ICUs for more than 48 h. Data regarding diagnosis, clinical conditions, therapies, treatments and outcomes of COVID-19 patients were also collected. Findings: From a total of 21,523 patients from 2006 to 2021, 3485 (16.2%) presented at least one HAI. We observed an increasing trend for both the incidence of patients with HAI and the incidence density of HAIs (P-trend <0.001). Compared with the pre-pandemic period, the incidence density of HAIs increased by about 15% in 2020-2021, with pneumoniae being the greatest contributors to this increase (P-trend <0.001). Moreover, incidence of HAIs was higher in ICUs dedicated to COVID-19 patients (P<0.001), who showed a greater risk of HAIs and death than patients without COVID-19 (P-values <0.001). Accordingly, the mortality in ICUs increased over the years and doubled during the pandemic (P-trend <0.001). Notably, co-infected patients had higher mortality (75.2%) than those with COVID-19 (66.2%) or HAI (39.9%) alone, and those without any infection (23.2%). Conclusions: Our analysis provides useful insight into whether and how the COVID-19 pandemic influenced HAI incidence and death in Italian ICUs, highlighting the need for evaluation of the long-term effects of the pandemic. (c) 2023 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Additional details
- URL
- https://hdl.handle.net/11567/1186406
- URN
- urn:oai:iris.unige.it:11567/1186406
- Origin repository
- UNIGE