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

M. Barchitta; A. Maugeri; G. Favara; R. Magnano San Lio; M. C. La Rosa; F. D'Ancona; A. Agodi; P. Murgia; M. D. Masia; I. Mura; S. Brusaferro; L. Arnoldo; C. Di Stefano; F. Lucchese; M. Lugano; S. Tardivo; F. Moretti; M. O. Bernasconi; F. Pappalardo; C. Pasquarella; E. Sicoli; M. T. Montagna; G. Caggiano; O. De Giglio; S. Fenaroli; R. Squeri; G. Cannavò; A. Pulvirenti; Alessia Pulvirenti; S. Catalano; A. R. Mattaliano; G. Castiglione; M. Astuto; G. La Camera; E. Panascia; A. M. Longhitano; G. Scrofani; M. R. Gallea; P. Civello; M. Milazzo; G. Calamusa; A. Giarratano; A. Di Benedetto; Adriano Di Benedetto; G. M.G. Rizzo; G. Manta; C. Angelone; R. Mancuso; R. Tetamo; L. M. Mella; I. Dei; I. Pandiani; A. Cannistrà; P. Piotti; M. Girardis; A. Barbieri; S. Borracino; R. Palermo; D. Di Stefano; A. Colombo; A. Romeo; M. Minerva; L. Fabiani; F. Marinangeli; M. M. D'Errico; A. Donati; R. Domizi; S. T. Saglimbene; A. Bianco; C. Vittori; G. B. Orsi; M. Scibilia; O. Calà; I. Giacinto; M. R. Amatucci; T. Principi; G. Di Fabio; V. Gobbini; M. P. Olori; Massimo Antonelli; Patrizia Laurenti; L. Condorelli; F. Ingala; S. Russo; P. Costa; L. Canonico; P. Farruggia; M. L. Cristina; M. Sartini; C. Arrigoni; Chiara Arrigoni; I. Galassi; V. M. Vinci

doi:10.1016/j.jhin.2023.07.021

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

M. Barchitta, A. Maugeri, G. Favara, R. Magnano San Lio, M. C. La Rosa, F. D'Ancona, A. Agodi, P. Murgia, M. D. Masia, I. Mura, S. Brusaferro, L. Arnoldo, C. Di Stefano, F. Lucchese, M. Lugano, S. Tardivo, F. Moretti, M. O. Bernasconi, F. Pappalardo, C. PasquarellaE. Sicoli, M. T. Montagna, G. Caggiano, O. De Giglio, S. Fenaroli, R. Squeri, G. Cannavò, A. Pulvirenti, Alessia Pulvirenti, S. Catalano, A. R. Mattaliano, G. Castiglione, M. Astuto, G. La Camera, E. Panascia, A. M. Longhitano, G. Scrofani, M. R. Gallea, P. Civello, M. Milazzo, G. Calamusa, A. Giarratano, A. Di Benedetto, Adriano Di Benedetto, G. M.G. Rizzo, G. Manta, C. Angelone, R. Mancuso, R. Tetamo, L. M. Mella, I. Dei, I. Pandiani, A. Cannistrà, P. Piotti, M. Girardis, A. Barbieri, S. Borracino, R. Palermo, D. Di Stefano, A. Colombo, A. Romeo, M. Minerva, L. Fabiani, F. Marinangeli, M. M. D'Errico, A. Donati, R. Domizi, S. T. Saglimbene, A. Bianco, C. Vittori, G. B. Orsi, M. Scibilia, O. Calà, I. Giacinto, M. R. Amatucci, T. Principi, G. Di Fabio, V. Gobbini, M. P. Olori, Massimo Antonelli, Patrizia Laurenti, L. Condorelli, F. Ingala, S. Russo, P. Costa, L. Canonico, P. Farruggia, M. L. Cristina, M. Sartini, C. Arrigoni, Chiara Arrigoni, I. Galassi, V. M. Vinci

Risultato della ricerca: Contributo in rivista › Articolo in rivista

Abstract

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/).

Lingua originale	English
pagine (da-a)	124-131
Numero di pagine	8
Rivista	THE JOURNAL OF HOSPITAL INFECTION
Volume	140
DOI	https://doi.org/10.1016/j.jhin.2023.07.021
Stato di pubblicazione	Pubblicato - 2023

Keywords

COVID-19
Healthcare-associated infections
Intensive care unit
Nosocomial infections
Pandemic
SARS-CoV-2

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10.1016/j.jhin.2023.07.021

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Barchitta, M., Maugeri, A., Favara, G., Lio, R. M. S., 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., ... Vinci, V. M. (2023). 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. THE JOURNAL OF HOSPITAL INFECTION, 140, 124-131. https://doi.org/10.1016/j.jhin.2023.07.021

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title = "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",

abstract = "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/).",

keywords = "COVID-19, Healthcare-associated infections, Intensive care unit, Nosocomial infections, Pandemic, SARS-CoV-2, COVID-19, Healthcare-associated infections, Intensive care unit, Nosocomial infections, Pandemic, SARS-CoV-2",

author = "M. Barchitta and A. Maugeri and G. Favara and Lio, {R. Magnano San} and {La Rosa}, {M. C.} and F. D'Ancona and A. Agodi and P. Murgia and Masia, {M. D.} and I. Mura and S. Brusaferro and L. Arnoldo and {Di Stefano}, C. and F. Lucchese and M. Lugano and S. Tardivo and F. Moretti and Bernasconi, {M. O.} and F. Pappalardo and C. Pasquarella and E. Sicoli and Montagna, {M. T.} and G. Caggiano and {De Giglio}, O. and S. Fenaroli and R. Squeri and G. Cannav{\`o} and A. Pulvirenti and Alessia Pulvirenti and S. Catalano and Mattaliano, {A. R.} and G. Castiglione and M. Astuto and {La Camera}, G. and E. Panascia and Longhitano, {A. M.} and G. Scrofani and Gallea, {M. R.} and P. Civello and M. Milazzo and G. Calamusa and A. Giarratano and {Di Benedetto}, A. and {Di Benedetto}, Adriano and Rizzo, {G. M.G.} and G. Manta and C. Angelone and R. Mancuso and R. Tetamo and Mella, {L. M.} and I. Dei and I. Pandiani and A. Cannistr{\`a} and P. Piotti and M. Girardis and A. Barbieri and S. Borracino and R. Palermo and {Di Stefano}, D. and A. Colombo and A. Romeo and M. Minerva and L. Fabiani and F. Marinangeli and D'Errico, {M. M.} and A. Donati and R. Domizi and Saglimbene, {S. T.} and A. Bianco and C. Vittori and Orsi, {G. B.} and M. Scibilia and O. Cal{\`a} and I. Giacinto and Amatucci, {M. R.} and T. Principi and {Di Fabio}, G. and V. Gobbini and Olori, {M. P.} and Massimo Antonelli and Patrizia Laurenti and L. Condorelli and F. Ingala and S. Russo and P. Costa and L. Canonico and P. Farruggia and Cristina, {M. L.} and M. Sartini and C. Arrigoni and Chiara Arrigoni and I. Galassi and Vinci, {V. M.}",

year = "2023",

doi = "10.1016/j.jhin.2023.07.021",

language = "English",

volume = "140",

pages = "124--131",

journal = "THE JOURNAL OF HOSPITAL INFECTION",

issn = "0195-6701",

publisher = "Harcourt Publishers Limited:Foots Cray High Street, Sidcup Kent DA14 5HP United Kingdom:011 44 20 83085700, EMAIL: [email protected], INTERNET: http://www.harcourt-international.com, Fax: 011 44 20 83085876",

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Barchitta, M, Maugeri, A, Favara, G, Lio, RMS, La Rosa, MC, D'Ancona, F, Agodi, A, Murgia, P, Masia, MD, Mura, I, Brusaferro, S, Arnoldo, L, Di Stefano, C, Lucchese, F, Lugano, M, Tardivo, S, Moretti, F, Bernasconi, MO, Pappalardo, F, Pasquarella, C, Sicoli, E, Montagna, MT, Caggiano, G, De Giglio, O, Fenaroli, S, Squeri, R, Cannavò, G, Pulvirenti, A, Pulvirenti, A, Catalano, S, Mattaliano, AR, Castiglione, G, Astuto, M, La Camera, G, Panascia, E, Longhitano, AM, Scrofani, G, Gallea, MR, Civello, P, Milazzo, M, Calamusa, G, Giarratano, A, Di Benedetto, A, Di Benedetto, A, Rizzo, GMG, Manta, G, Angelone, C, Mancuso, R, Tetamo, R, Mella, LM, 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, MM, Donati, A, Domizi, R, Saglimbene, ST, Bianco, A, Vittori, C, Orsi, GB, Scibilia, M, Calà, O, Giacinto, I, Amatucci, MR, Principi, T, Di Fabio, G, Gobbini, V, Olori, MP, Antonelli, M , Laurenti, P, Condorelli, L, Ingala, F, Russo, S, Costa, P, Canonico, L, Farruggia, P, Cristina, ML, Sartini, M, Arrigoni, C, Arrigoni, C, Galassi, I & Vinci, VM 2023, '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', THE JOURNAL OF HOSPITAL INFECTION, vol. 140, pagg. 124-131. https://doi.org/10.1016/j.jhin.2023.07.021

TY - JOUR

T1 - 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

AU - Barchitta, M.

AU - Maugeri, A.

AU - Favara, G.

AU - Lio, R. Magnano San

AU - La Rosa, M. C.

AU - D'Ancona, F.

AU - Agodi, A.

AU - Murgia, P.

AU - Masia, M. D.

AU - Mura, I.

AU - Brusaferro, S.

AU - Arnoldo, L.

AU - Di Stefano, C.

AU - Lucchese, F.

AU - Lugano, M.

AU - Tardivo, S.

AU - Moretti, F.

AU - Bernasconi, M. O.

AU - Pappalardo, F.

AU - Pasquarella, C.

AU - Sicoli, E.

AU - Montagna, M. T.

AU - Caggiano, G.

AU - De Giglio, O.

AU - Fenaroli, S.

AU - Squeri, R.

AU - Cannavò, G.

AU - Pulvirenti, A.

AU - Pulvirenti, Alessia

AU - Catalano, S.

AU - Mattaliano, A. R.

AU - Castiglione, G.

AU - Astuto, M.

AU - La Camera, G.

AU - Panascia, E.

AU - Longhitano, A. M.

AU - Scrofani, G.

AU - Gallea, M. R.

AU - Civello, P.

AU - Milazzo, M.

AU - Calamusa, G.

AU - Giarratano, A.

AU - Di Benedetto, A.

AU - Di Benedetto, Adriano

AU - Rizzo, G. M.G.

AU - Manta, G.

AU - Angelone, C.

AU - Mancuso, R.

AU - Tetamo, R.

AU - Mella, L. M.

AU - Dei, I.

AU - Pandiani, I.

AU - Cannistrà, A.

AU - Piotti, P.

AU - Girardis, M.

AU - Barbieri, A.

AU - Borracino, S.

AU - Palermo, R.

AU - Di Stefano, D.

AU - Colombo, A.

AU - Romeo, A.

AU - Minerva, M.

AU - Fabiani, L.

AU - Marinangeli, F.

AU - D'Errico, M. M.

AU - Donati, A.

AU - Domizi, R.

AU - Saglimbene, S. T.

AU - Bianco, A.

AU - Vittori, C.

AU - Orsi, G. B.

AU - Scibilia, M.

AU - Calà, O.

AU - Giacinto, I.

AU - Amatucci, M. R.

AU - Principi, T.

AU - Di Fabio, G.

AU - Gobbini, V.

AU - Olori, M. P.

AU - Antonelli, Massimo

AU - Laurenti, Patrizia

AU - Condorelli, L.

AU - Ingala, F.

AU - Russo, S.

AU - Costa, P.

AU - Canonico, L.

AU - Farruggia, P.

AU - Cristina, M. L.

AU - Sartini, M.

AU - Arrigoni, C.

AU - Arrigoni, Chiara

AU - Galassi, I.

AU - Vinci, V. M.

PY - 2023

Y1 - 2023

N2 - 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/).

AB - 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/).

KW - COVID-19

KW - Healthcare-associated infections

KW - Intensive care unit

KW - Nosocomial infections

KW - Pandemic

KW - SARS-CoV-2

KW - COVID-19

KW - Healthcare-associated infections

KW - Intensive care unit

KW - Nosocomial infections

KW - Pandemic

KW - SARS-CoV-2

UR - http://hdl.handle.net/10807/304585

U2 - 10.1016/j.jhin.2023.07.021

DO - 10.1016/j.jhin.2023.07.021

M3 - Article

SN - 0195-6701

VL - 140

SP - 124

EP - 131

JO - THE JOURNAL OF HOSPITAL INFECTION

JF - THE JOURNAL OF HOSPITAL INFECTION

ER -

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

Abstract

Keywords

OSS delle Nazioni Unite

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