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Incidence and Impact of Healthcare-associated Infections on Patients Primarily Admitted with Sepsis and Non-sepsis
Chintamani Abhishek1, Bala Prakash1, Babu K Abraham1
1Department of Critical Care, Apollo Hospitals, Chennai, Tamil Nadu, India.
Insights
Healthcare-associated infections (HAI) occur similarly in sepsis and non-sepsis ICU patients. However, sepsis patients experience more complications and longer ICU stays, though mortality rates are comparable.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Healthcare-associated infections (HAI) are a significant concern in intensive care units (ICUs).
- Understanding the impact of initial diagnosis (sepsis vs. non-sepsis) on HAI incidence and outcomes is crucial for patient management.
Purpose of the Study:
- To compare the incidence and outcomes of HAI in ICU patients admitted with sepsis versus non-sepsis diagnoses.
- To analyze differences in complications, ICU length of stay (LOS), and 30-day mortality between these groups.
Main Methods:
- A prospective, observational study conducted at a single tertiary medical-surgical ICU.
- Included 271 ICU patients with LOS > 48 hours, comparing 106 sepsis patients with 165 non-sepsis patients.
- Collected baseline data, recorded HAI occurrence, organ support, and patient outcomes.
Main Results:
- No significant difference in HAI incidence between sepsis (29.2%) and non-sepsis (24.4%) groups (p=0.07).
- Sepsis patients had significantly higher rates of complications including acute kidney injury (AKI), shock, and need for mechanical ventilation (MV).
- Sepsis patients experienced a longer ICU LOS (12.2 days vs. 8.8 days; p=0.01) but similar 30-day mortality rates.
Conclusions:
- The incidence of HAI is similar regardless of whether patients are admitted with sepsis or non-sepsis diagnoses.
- Patients admitted with sepsis face increased risks of organ failure and prolonged ICU stays due to HAI.
- HAI does not significantly alter 30-day mortality between sepsis and non-sepsis patient groups.
Abstract:
Objectives: To compare the incidence of healthcare-associated infections (HAI) and their outcomes between patients admitted to the ICU with sepsis and those admitted with non-sepsis diagnoses. Materials and methods: We performed a single-center, prospective, observational study of ICU patients at a tertiary level medical-surgical unit from April 2018 to October 2018. All patients admitted to the ICU with a length of stay (LOS) > 48 hours were included. Baseline data including demographics, comorbidities, and severity of illness scores were collected. Index occurrence of HAI in all these patients was noted and data regarding organ support and patient outcomes were recorded. The incidence, complications, ICU LOS, and 30-day mortality of HAI were compared between the patients admitted to ICU originally with sepsis and non-sepsis diagnoses. Results: A total of 271 patients were evaluated in our study (N = 106 for the sepsis group and N = 165 for the non-sepsis group). No significant difference between the groups was found in the incidence of HAI (29.2% in sepsis group vs 24.4% in non-sepsis group; p = 0.07). Complications (acute kidney injury (AKI): 71 vs 45%; p = 0.01, shock: 81 vs 55%; p = 0.05, need for mechanical ventilation (MV): 30 vs 15%; p = 0.04) were more common in sepsis group compared to the non-sepsis group. The ICU LOS (12.2 ± 5.2 days vs 8.8 ± 2.05 days; p = 0.01) was significantly longer in the sepsis group. There was no significant difference in 30-day mortality between the groups (45 vs 25%; p = 0.07). Conclusion: The incidence of HAI seems to be similar between patients admitted with sepsis and non-sepsis diagnoses. However, patients admitted with sepsis develop higher rates of organ failure secondary to HAI and have a longer ICU LOS compared to patients admitted with non-sepsis diagnoses. The mortality rate of HAI did not differ between these two groups. How to cite this article: Chintamani A, Prakash B, Abraham BK, Kumar S, Ramakrishnan N, Venkataraman R. Incidence and Impact of Healthcare-associated Infections on Patients Primarily Admitted with Sepsis and Non-sepsis Diagnoses. Indian J Crit Care Med 2021;25(3): 292-295.
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