According to the latest study presented at the 22nd European Congress of Clinical Microbiology and Infectious Diseases, elderly patients treated with central catheter and/or mechanical ventilation devices in intensive care units are at a very high risk for getting hospital-acquired infections (HAIs). An analysis of an American hospital database showed that patients in ICU with HAI had four times higher rate of in-house mortality when compared to those without HAI.
Florence Joly, PharmD, from global evidence and value development at Sanofi in Paris, France, the lead of the study, reported that devices like central catheter or mechanical ventilation increased the risk of HAI by three times. The infections include bloodstream infection, nosocomial pneumonia, and surgical-site infection. “The rate of infection increased if the patient came from emergency department and with age”, commented Dr. Joly. The period of stay in the ICU also increased considerably from a mean of 8.1 days to 15.8 days. The longest stay was found for surgical-site infections.
The most common cause of mortality was bloodstream infection followed by hospital-acquired pneumonia and surgical-site infection. Analysis was conducted on a database that covers 20% of the hospital discharges in the US. The researchers analyzed the data from 2007 to 2009. Up to 4,60,000 patients were covered in this analysis.
“Such an analysis provides a quick snapshot of the national situation, and also helps to follow the trends, and allow risk analysis and cost effectiveness checks," commented Joly. The study helped to get a better idea about the burden of the disease and infection, especially in the ICU, along with the financial impact of the same.
According to Christian Brun-Buisson, MD, PhD, professor of medicine and intensive care at Université Paris-Est Créteil, and director of the medical intensive care unit at Hôpital Henri Mondor in Créteil, France, this study confirmed the burden of HAI on ICU patients. It also confirmed the role of invasive devices in the risk of HAI. He commented that reducing the exposure to devices would be the best way to reduce infections. Moreover, efforts focusing on developing devices that are less prone to colonization also might be helpful.
He also added that the study results have to be considered with much caution as the consequences of HAI on morbidity and mortality have been overestimated. This may lead to unrealistic expectations of the impact from preventive strategies.
Centers for Disease Control and Prevention report of 2011 had shown that initiation of a bundle protocol was shown to be an effective method to reduce ventilator-acquired pneumonia. Kenneth B. Christopher, MD, from Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, commented that the study underscore the importance of changing behavior in the clinical setting.