COVID-19 Secondary Infections in ICU Patients and Prevention Control Measures: A Preliminary Prospective Multicenter Study
Sergio Ruiz-Santana,
María-Luisa Mora-Quintero,
Pedro Saavedra,
Raquel Montiel-González,
Catalina Sánchez-Ramírez,
Guillermo Pérez-Acosta,
Mar Martín-Velasco,
Cristóbal Rodríguez-Mata,
José-Manuel Lorenzo-García,
Dácil Parrilla-Toribio,
Tanya Carrillo-García,
Juan-Carlos Martín-González
Affiliations
Sergio Ruiz-Santana
Intensive Care Unit, Hospital Universitario Dr. Negrín, University of Las Palmas de Gran Canaria, Barranco de la Ballena s/n, E-35010 Las Palmas de Gran Canaria, Spain
María-Luisa Mora-Quintero
Intensive Care Unit, Hospital Universitario de Canarias (Tenerife), Carretera de Ofra s/n, E-38320 San Cristóbal de La Laguna, Spain
Pedro Saavedra
Department of Mathematics, University of Las Palmas de Gran Canaria, E-35010 Las Palmas de Gran Canaria, Spain
Raquel Montiel-González
Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain
Catalina Sánchez-Ramírez
Intensive Care Unit, Hospital Universitario Dr. Negrín, University of Las Palmas de Gran Canaria, Barranco de la Ballena s/n, E-35010 Las Palmas de Gran Canaria, Spain
Guillermo Pérez-Acosta
Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Marítima del Sur s/n, E-35016 Las Palmas de Gran Canaria, Spain
Mar Martín-Velasco
Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain
Cristóbal Rodríguez-Mata
Intensive Care Unit, Hospital Universitario Dr. Negrín, University of Las Palmas de Gran Canaria, Barranco de la Ballena s/n, E-35010 Las Palmas de Gran Canaria, Spain
José-Manuel Lorenzo-García
Intensive Care Unit, Hospital Universitario de Canarias (Tenerife), Carretera de Ofra s/n, E-38320 San Cristóbal de La Laguna, Spain
Dácil Parrilla-Toribio
Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain
Tanya Carrillo-García
Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Marítima del Sur s/n, E-35016 Las Palmas de Gran Canaria, Spain
Juan-Carlos Martín-González
Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Marítima del Sur s/n, E-35016 Las Palmas de Gran Canaria, Spain
The incidence of secondary infections in critically ill coronavirus disease 2019 (COVID-19) patients is worrisome. We investigated whether selective digestive decontamination (SDD) added to infection control measures during an intensive care unit (ICU) stay modified these infection rates. Methods: A retrospective observational cohort study was carried out in four ICUs in Spain. All consecutive ventilated patients with a SARS-CoV-2 infection engaged in national infection control programs between 1 March and 10 December 2020 were investigated. Patients were grouped into two cohorts according to the site of ICU admission. Secondary relevant infections were included. Infection densities corresponding to ventilator-associated pneumonia (VAP), catheter bacteremia, secondary bacteremia, and multi-resistant germs were obtained as the number of events per 1000 days of exposure and were compared between SDD and non-SDD groups using Poisson regression. Factors that had an independent association with mortality were identified using multidimensional logistic analysis. Results: There were 108 patients in the SDD cohort and 157 in the non-SDD cohort. Patients in the SDD cohort showed significantly lower rates (p p = 0.006). Differences in mortality according to SDD were not found. Conclusion: The implementation of SDD in infection control programs significantly reduced the incidence of VAP and MDR infections in critically ill SARS-CoV-2 infected patients.
