Factors associated with the development of healthcare-associated infections in the intensive care unit: a literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i5.28125

Keywords:

Intensive care units; Hospital infections; Health professionals.

Abstract

Infection is a common occurrence among intensive care unit (ICU) patients and a prerequisite for the development of sepsis. Patients treated in the ICU are at increased risk of healthcare-associated infections (HAIs) due to the invasive nature of many treatments, such as mechanical ventilation, urinary catheterization, and central venous access. The present study aims to describe the factors that lead to the development of infection related to health care in the intensive care unit. This is a study with a qualitative approach, where an integrative literature review was adopted, carried out through the Virtual Health Library (VHL) in Pubmed databases, using the crossings of the English descriptors “Hospital infections”, “Intensive care unit” and “health care”. For the evaluation of the research problem and its stratification, the PVO strategy was used. The following guiding question was formulated: What are the factors that lead to the emergence of infections in the intensive care unit? Nosocomial infections in intensive care units are most commonly associated with invasive treatments and diagnostic techniques, as well as the use of life support or monitoring devices directly or indirectly. Gram-negative microorganisms were identified more frequently than gram-positive microorganisms in the culture. Advanced age, comorbid metastatic cancer, HIV infection, and heart failure were independently associated with a higher risk of death. This variation was associated with patient and disease-specific factors and the care process and country-to-country differences.

References

Alfouzan, W., Dhar, R., Abdo, N. M., Alali, W. Q., & Rabaan, A. A. (2021). Epidemiology and Microbiological Profile of Common Healthcare Associated Infections among Patients in the Intensive Care Unit of a General Hospital in Kuwait: A Retrospective Observational Study. Journal of epidemiology and global health, 11(3), 302–309.

Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: a systematic review and meta-analysis of randomised crossover trials. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 21(46).

Araç, E., Kaya, Ş., Parlak, E., Büyüktuna, S. A., Baran, A. İ., Akgül, F., Gökler, M. E., Aksöz, S., Sağmak Tartar, A., Tekin, R., Yıldız, Y., & Günay, E. (2019). Yoğun Bakım Ünitelerindeki Enfeksiyonların Değerlendirilmesi: Çok Merkezli Nokta Prevalans Çalışması [Evaluation of Infections in Intensive Care Units: A Multicentre Point-Prevalence Study]. Mikrobiyol Bul. 53(4):364-373.

Castaldi, S., Luconi, E., Marano, G., Auxilia, F., Maraschini, A., Bono, P., Ungaro, R., Bandera, A., Boracchi, P., & Biganzoli, E. (2020). Infecções hospitalares adquiridas em pacientes com COVID-19 em unidade de terapia subintensiva. Acta biomédica : Atenei Parmensis , 91 (3).

Duszynska, W., Rosenthal, V. D., Szczesny, A., Zajaczkowska, K., Fulek, M., & Tomaszewski, J. (2020). Device associated -health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015-2017). BMC infectious diseases, 20(1), 761.

Frost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R., Alexandrou, E., & Hillman, K. M. (2016). Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Crit Care (Londres, Inglaterra) , 20 (1), 379.

Galvão, C.M., Mendes, K.D.S., Silveira, R.C.C.P. (2010) . Revisão integrativa: método de revisão para sintetizar as evidências disponíveis na literatura. In: Brevidelli MM, Sertório SCM. Trabalho de conclusão de curso: guia prático para docentes e alunos da área da saúde. 105-26.

Gaspar, G. G., Ferreira, L. R., Feliciano, C. S., Campos Júnior, C. P., Molina, F., Vendruscolo, A., Bradan, G., Lopes, N., Martinez, R., & Bollela, V. R. (2021). Pre- and post-COVID-19 evaluation of antimicrobial susceptibility for healthcare-associated infections in the intensive care unit of a tertiary hospital. Revista da Sociedade Brasileira de Medicina Tropical, 54, e00902021.

Kołpa, M., Wałaszek, M., Gniadek, A., Wolak, Z., & Dobroś, W. (2018). Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. International journal of environmental research and public health, 15(1), 112.

Mazzeffi, M., Galvagno, S., & Rock, C. (2021). Prevention of Healthcare-associated Infections in Intensive Care Unit Patients. Anesthesiology. 135(6):1122-1131.

Musuuza, J. S., Guru, P. K., O'Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E., & Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis. BMC infectious diseases, 19(1), 416.

Musu, M., Lai, A., Mereu, N. M., Galletta, M., Campagna, M., Tidore, M., Piazza, M. F., Spada, L., Massidda, M. V., Colombo, S., Mura, P., & Coppola, R. C. (2017). Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units. Journal of preventive medicine and hygiene, 58(3), E231–E237.

Russo, A., Gavaruzzi, F., Ceccarelli, G., Borrazzo, C., Oliva, A., Alessandri, F., Magnanimi, E., Pugliese, F., & Venditti, M. (2022). Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit. Infection, 50(1), 83–92.

Rhee, C., Dantes, R., Epstein, L., Murphy, D. J., Seymour, C. W., Iwashyna, T. J., Kadri, S. S., Angus, D. C., Danner, R. L., Fiore, A. E., Jernigan, J. A., Martin, G. S., Septimus, E., Warren, D. K., Karcz, A., Chan, C., Menchaca, J. T., Wang, R., Gruber, S. & Klompas, M. (2017). Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014. JAMA, 318(13), 1241–1249.

Strich, J. R., & Palmore, T. N. (2017). Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit. Infectious disease clinics of North America, 31(3), 535–550.

Tomaszewski, D., Rybicki, Z., & Duszyńska, W. (2019). The Polish Prevalence of Infection in Intensive Care (PPIC): A one-day point prevalence multicenter study. Adv Clin Exp Med. 28(7):907-912. ‘

Tajeddin, E., Rashidan, M., Razaghi, M., Javadi, S. S., Sherafat, S. J., Alebouyeh, M., Sarbazi, M. R., Mansouri, N., & Zali, M. R. (2016). The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections. J Infect Public Health. 9(1):13-23.

Vincent, J. L., Sakr, Y., Singer, M., Martin-Loeches, I., Machado, F. R., Marshall, J. C., Finfer, S., Pelosi, P., Brazzi, L., Aditianingsih, D., Timsit, J. F., Du, B., Wittebole, X., Máca, J., Kannan, S., Gorordo-Delsol, L. A., De Waele, J. J., Mehta, Y., Bonten, M., & Khanna, A. K. (2020). Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017. JAMA, 323(15), 1478–1487.

Yin, M., Tambyah, P. A., & Perencevich, E. N. (2020). Infection, Antibiotics, and Patient Outcomes in the Intensive Care Unit. JAMA. 21;323(15):1451-1452.

Wang, Y. C., Shih, S. M., Chen, Y. T., Hsiung, C. A., & Kuo, S. C. (2020). Clinical and economic impact of intensive care unit-acquired bloodstream infections in Taiwan: a nationwide population-based retrospective cohort study. BMJ open, 10(11), e037484.

Published

01/04/2022

How to Cite

SILVA, B. B. L. da; ALVES, A. K. R.; SEREJO JUNIOR, F. das C. da S. .; LIMA , G. V. de S. .; LIMA, T. R. C. C. .; BRITO, F. E. V. .; RODRIGUES , Érika P. de S. M. .; COELHO , Ítallo da S. .; COSTA , L. M. de A. L. .; BRANDÃO , B. L. . Factors associated with the development of healthcare-associated infections in the intensive care unit: a literature review. Research, Society and Development, [S. l.], v. 11, n. 5, p. e14711528125, 2022. DOI: 10.33448/rsd-v11i5.28125. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28125. Acesso em: 5 dec. 2024.

Issue

Section

Health Sciences