The Covid-19 pandemic scenario triggered a global health crisis that contributed to an increased incidence of infections by multidrug-resistant (MDR) bacteria in patients hospitalized in Intensive Care Units (ICUs) due to several factors, including prolonged hospital stay, shortage of personal protective equipment, insufficient human resources, and indiscriminate use of antimicrobials. The objective of this study was to evaluate the frequency of infections by MDR bacteria and their association with length of hospital stay and duration of use of invasive devices in patients diagnosed with Covid-19 hospitalized in ICUs. A cross-sectional study developed with secondary data from medical records of patients hospitalized in ICUs from January 2020 to December 2022. The association between length of hospital stay and duration of use of invasive devices (endotracheal tube, arterial and central venous access, indwelling urinary catheter) with the occurrence of infections by MDR bacteria was evaluated using Student’s t-test and Logistic Regression, with a significance level of 0.05. Among 199 patients included, 61.3% were younger than 60 years and 51.8% were male. One quarter of the sample (24.7%) had a positive culture for MDR bacteria. The mean ICU length of stay was 10.8 days (19.0 and 8.1 days for patients with and without MDR bacterial infection, respectively), and each additional day of ICU stay increased the chance of infection by multidrug-resistant bacteria by 13.0% (p < 0.001). The mean duration of use of invasive devices ranged from 8.4 to 8.8 days for patients without MDR bacterial infections, compared with 15.8 to 19.0 days for those diagnosed with MDR bacterial infections (p < 0.001). In general, the chance of occurrence of MDR bacterial infections increased by 10 to 12% for each additional day of use of invasive devices (p < 0.001). The results of this study demonstrate a high frequency of infections caused by MDR bacteria among Covid-19 patients hospitalized in ICUs, with progressively increased risk as hospital stay and the use of invasive devices are prolonged. These findings reinforce the need to intensify and improve strategies for the prevention and control of healthcare-associated infections in the intensive care environment.
Santos et al. (Sun,) studied this question.