Healthcare associated infections among COVID-19 patients; Incidence, mortality, and risk factors | ||
| The Egyptian Journal of Community Medicine | ||
| Volume 43, Issue 4, October 2025, Pages 256-264 PDF (1.15 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejcm.2025.338715.1346 | ||
| Authors | ||
| Samar Saaed Morsi1; Kholoud Mohammed Alfadhalh2; Wafaa Seddik Hamza* 3 | ||
| 1Department of Microbiology and Immunology, faculty of Medicine, Zagazig university, Zagazig,Egypt | ||
| 2Infection Control Directorate,Ministry of Health, Kuwait | ||
| 3Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt | ||
| Abstract | ||
| Background: Healthcare-associated infections (HAIs) among COVID-19 patients is a challenge, leading to prolonged hospitalizations, increased morbidity, and mortality. This study aimed to evaluate the incidence of HAIs, mortality, and identify related risk factors in COVID-19 patients. Methods: A descriptive multi-center retrospective cohort study was conducted using HAIs surveillance data among COVID-19 patients admitted to Ministry of Health Hospitals during the pandemic. Multivariate logistic regression was performed. Results: A total of 474 HAIs were identified among 459 patients, with an incidence rate of 4.9 per 100 patients at risk and 3.43 per 1000 patient days. The most common types of HAIs were bloodstream infections, pneumonia, and urinary tract infections. Central line-associated bloodstream infections were significantly higher in the intensive care units (ICUs) compared to wards. Two-thirds of the infections were device -associated. Multidrug-resistant organisms (MDROs) were involved in 61.9% of HAIs, with gram-negative bacteria accounting for 74.3% of cases. Klebsiella pneumoniae and Acinetobacter baumannii were the most common MDROs identified. The 30-day mortality rate among patients was 52.1%, with HAIs contributing to 31.4% of deaths. MDROs significantly contributed to patients' mortality. Conclusions: The study highlights the increased rates of HAIs during the COVID-19 pandemic, particularly in the ICU. The logistic regression analysis identified MDROs, duration of device usage and time from admission to infection onset as significant predictors of mortality in patients with bloodstream infections. These findings underscore the importance of strictly implementing appropriate infection prevention practices and antimicrobial stewardship programs to reduce mortality and negative outcomes in COVID-19 patients. | ||
| Keywords | ||
| Pandemic; mortality; healthcare-associated infections; multidrug-resistant pathogens | ||
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