Nosocomial infections amongst critically ill COVID-19 patients in Australia

Mahesh Ramanan; Aidan Burrell; Eldho Paul; Tony Trapani; Tessa Broadley; Steve McGloughlin; Craig French; Andrew Udy

doi:10.1016/j.jcvp.2021.100054

Nosocomial infections amongst critically ill COVID-19 patients in Australia

J Clin Virol Plus. 2021 Dec;1(4):100054. doi: 10.1016/j.jcvp.2021.100054. Epub 2021 Nov 11.

Authors

Mahesh Ramanan^{1

2

3}, Aidan Burrell^{4

5}, Eldho Paul⁵, Tony Trapani^{4

5}, Tessa Broadley^{4

5}, Steve McGloughlin^{4

5}, Craig French⁶, Andrew Udy⁵

Affiliations

¹ Caboolture Hospital, 120 McKean Street, Caboolture, Queensland, Australia.
² Critical Care Division, The George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, New South Wales, 2042, Australia.
³ School of Medicine, University of Queensland, St. Lucia, Queensland, 4072, Australia.
⁴ Department of Epidemiology and Preventative Medicine, School of Public Health, Monash University, Melbourne, Australia.
⁵ Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553St Kilda Road, Melbourne, Victoria, Australia.
⁶ Western Health, Furlong Road, St Albans, Victoria, Australia.

Abstract

Purpose: To determine the frequency of nosocomial infections including hospital-acquired pneumonia (HAP) and bloodstream infection (BSI), amongst critically ill patients with COVID-19 infection in Australian ICUs and to evaluate associations with mortality and length of stay (LOS).

Methods: The effect of nosocomial infections on hospital mortality was evaluated using hierarchical logistic regression models to adjust for illness severity and mechanical ventilation.

Results: There were 490 patients admitted to 55 ICUs during the study period. Adjusted odds ratio (OR) for hospital mortality was 1.61 (95% confidence interval (CI) 0.61-4.27, p = 0.3) when considering BSI, and 1.76 (95% CI 0.73-4.21, p = 0.2) for HAP. The average adjusted ICU LOS was significantly longer for patients with BSI (geometric mean 9.0 days vs 6.3 days, p = 0.04) and HAP (geometric mean 13.9 days vs 6.0 days p<0.001).

Conclusion: Nosocomial infection rates amongst patients with COVID-19 were low and their development was associated with a significantly longer ICU LOS.

Keywords: Bloodstream infections; COVID-19; Critical care; Healthcare-associated pneumonia; Nosocomial infections.