Infection and Drug Resistance (Jan 2023)

Clinical Impact and Risk Factors of Intensive Care Unit-Acquired Nosocomial Infection: A Propensity Score-Matching Study from 2018 to 2020 in a Teaching Hospital in China

  • Wang Y,
  • Ren J,
  • Yao Z,
  • Wang W,
  • Wang S,
  • Duan J,
  • Li Z,
  • Zhang H,
  • Zhang R,
  • Wang X

Journal volume & issue
Vol. Volume 16
pp. 569 – 579

Abstract

Read online

Yanhui Wang,1,* Jian Ren,2,* Zhiqing Yao,1 Wei Wang,3 Siyang Wang,2 Junfang Duan,3 Zhen Li,4 Huizi Zhang,1 Ruiqin Zhang,2 Xiaoru Wang3 1College of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 2Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 3Intensive Care Unit, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 4College of Pharmacy, Chonnam National University, Gwangju, Korea*These authors contributed equally to this workCorrespondence: Ruiqin Zhang; Xiaoru Wang, Email [email protected]; [email protected]: Nosocomial infection (NI) is associated with poor prognosis. The present study assessed the clinical and microbiological characteristics of NI patients in the intensive care unit (ICU) and investigated the clinical impact and risk factors for NI in ICU patients.Patients and Methods: An observational study was conducted in an adult general ICU. The electronic medical records of all patients admitted to the ICU for > 2 days from 2018– 2020 were analyzed retrospectively. Multivariate regression models were used to analyze the risk factors for NI in ICU patients. Propensity score-matching (PSM) was used to control the confounding factors between the case and control groups, thus analyzing the clinical impact of NIs.Results: The present study included 2425 patient admissions, of which 231 (9.53%) had NI. Acinetobacter baumannii (33.0%) was the most common bacteria. Long-term immunosuppressive therapy, disturbance of consciousness, blood transfusion, multiple organ dysfunction syndromes (MODS), treatment with three or more antibiotics, mechanical ventilation (MV), tracheotomy, the urinary catheter (UC), nasogastric catheter, and central venous catheter (CVC) were risk factors for NI in the ICU patients. After PSM, patients with NI had a prolonged length of stay (LOS) in the ICU and hospital, significant hospitalization expenses (all p< 0.001), increased mortality (p=0.027), and predicted mortality (p=0.007). The differences in the ICU and hospital LOSs among three pathogens were statistically significant (p< 0.001); the results of the Escherichia coli infection group were lower than the other two pathogenic groups.Conclusion: NI was associated with poor outcomes. The risk factors for NI identified in this study provided further insight into preventing NI.Keywords: nosocomial infection, epidemiology, North China, propensity score-matching, intensive care unit, retrospective study

Keywords