The burden of healthcare-associated infections in Brazil: multi-hospital point prevalence using a matched case-control study
Abstract
ABSTRACT Background: Healthcare-associated infections (HAIs) have a significant impact on patient care worldwide and have serious implications for the Brazilian healthcare system. Objectives: This study aimed to describe the trends in HAIs in adult intensive care units (ICUs) using data from a national point-prevalence survey. DESIGN AND SETTING: A point-prevalence study was conducted in 2019 across adult intensive ICUs in large acute care hospitals in Brazil. METHODS: A matched case-control study was performed to assess the risk factors associated with the development of infection. RESULTS: A total of 386 patients from 15 hospitals were studied, of whom 102 (26.4%; 102/386) were infected, and 76.5% had at least one ICU-acquired infection. In clinical-surgical ICUs (CSU), the prevalence of infections acquired in the unit was 77.9%, whereas in Coronary ICUs (COU), it was 68.7%. There was a predominance of pneumonia (51.0%), mainly caused by Gram-negative non-fermenters, and bloodstream infections (34.4%), predominantly caused by coagulase-negative Staphylococcus (CoNS). In the risk factor analysis, cancer and general antimicrobial use were independently associated. CONCLUSION: This study found a high burden of HAIs in adult ICUs in Brazil, mainly associated with the high use of antibiotics for infections and a worse prognosis.
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