第二个 COVID-19 大流行年期间 PVC-BSI 的增加:导管和患者特征分析。

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES Antimicrobial Resistance and Infection Control Pub Date : 2024-10-08 DOI:10.1186/s13756-024-01476-4
Eva Pianca, Marie-Céline Zanella, Basilice Minka Obama, Aude Nguyen, Loïc Fortchantre, Marie-Noëlle Chraiti, Stephan Harbarth, Gaud Catho, Aleece MacPhail, Niccolò Buetti
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引用次数: 0

摘要

背景:据报道,在 COVID-19 大流行期间,医院内感染不断增加。目的:描述 COVID-19 大流行期间 PVC-BSI 的流行病学和风险因素:我们对瑞士一家拥有 2100 张病床的医院网络中前瞻性收集的 PVC-BSI 数据进行了回顾性队列研究。研究纳入了 2020 年 1 月 1 日至 2021 年 12 月 31 日期间植入 PVC 的成人患者。通过对患者和导管特征的描述性分析以及单变量边际考克斯模型,确定了PVC-BSI的风险因素。大多数PVC-BSI都是由急诊科(76%)或外科病房(22%)插入的导管引起的。2021 年的 PVC-BSI 比 2020 年有所增加(危险比 2021 年比 2020 年=2.73;95% 置信区间 1.19-6.29),其中金黄色葡萄球菌感染率(1/10,10%;5/27,19%)和多微生物感染率(0/10,0%;4/27,15%)均高于 2021 年。在整个研究期间,PVC插入情况、患者特征和导管特征保持相似。PVC-BSI风险与入住重症监护室(ICU)和使用宽规格导管有关(结论:COVID-19大流行期间PVC-BSI的增加不能仅由导管或患者因素来解释,可能是全系统变化的结果。PVC-BSI事件主要发生在急症护理环境中,包括急诊科、外科病房和重症监护室。
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Increase in PVC-BSI during the second COVID-19 pandemic year: analysis of catheter and patient characteristics.

Background: Increasing nosocomial infections during the COVID-19 pandemic have been reported. However, data describing peripheral venous catheter associated bloodstream infections (PVC-BSI) are limited.

Aims: To describe the epidemiology and risk factors for PVC-BSI during the COVID-19 pandemic.

Methods: We conducted retrospective cohort study of prospectively collected PVC-BSI data in a 2100 bed hospital network in Switzerland. Adult patients with a PVC inserted between January 1, 2020 and December 31, 2021 were included. Risk factors for PVC-BSI were identified through descriptive analysis of patient and catheter characteristics, and univariable marginal Cox models.

Results: 206,804 PVCs and 37 PVC-BSI were analysed. Most PVC-BSI were attributed to catheters inserted in the Emergency department (76%) or surgical wards (22%). PVC-BSI increased in 2021 compared to 2020 (hazard ratio 2021 vs. 2020 = 2.73; 95% confidence interval 1.19-6.29), with a numerically higher rate of Staphylococcus aureus (1/10, 10%, vs. 5/27, 19%) and polymicrobial infection (0/10, 0% vs. 4/27, 15%). PVC insertions, patient characteristics, and catheter characteristics remained similar across the study period. PVC-BSI risk was associated with admission to the intensive care unit (ICU), and use of wide gauge catheter ( < = 16G).

Conclusion: Increased PVC-BSI during the COVID-19 pandemic was not explained by catheter or patient factors alone, and may result from system-wide changes. PVC-BSI events are primarily attributed to acute care settings, including the emergency department, surgical wards, and the ICU.

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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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