Clinical epidemiological characterization of critical ill patients with community-acquired infections during COVID-19
Keywords:
Community-acquired infections, Epidemiology, Critical patient, Intensive care unit, COVID-19.Abstract
Introduction: critically ill patients require admission to intensive care units due to community-acquired infections.
Objective: to characterize, from a clinical and epidemiological point of view, critical ill patients with community-acquired infections during COVID-19.
Results: 52.7% of the patients were female. The mean age was 40.2 years (95% CI: 37.8-42.4). The mean Acute Physiology and Chronic Health Evaluation II (APACHE II) was estimated at 11.8 (95% CI: 9.7-12.2). The mean Sequential Organ Failure Assessment (SOFA) scale was 1.8 (95% CI: 1.4-2.2). 31.7% of the patients were hypertensive and 19.4% diabetic. Intra-abdominal infection was the main location (52.7%), followed by pneumonia (34.7%). 98.7% had antimicrobials on admission and 26.3% had artificial mechanical ventilation.
Conclusions: the patients are mostly characterized by being female, being in the fourth decade of life, developing alterations in their physiological systems and organ dysfunction, and having high blood pressure and diabetes mellitus; intra-abdominal infection or pneumonia as well as requiring treatment with antimicrobials, invasive mechanical ventilation and vasoactive drugs.
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1. Szabo BG, Kiss R, Lenart KS, Marosi B, Vad E, Lakatos B, et al. Clinical and microbiological characteristics and outcomes of community-acquired sepsis among adults: a single center, 1-year retrospective observational cohort study from Hungary. BMC Infect Dis [Internet]. 2019 [citado 2023 Dec 20]; 19(1):584. Disponible en: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4219-5
2. Pan J, Bu W, Guo T, Geng Z, Shao M. Development and validation of an in-hospital mortality risk prediction model for patients with severe community-acquired pneumonia in the intensive care unit. BMC Pulm Med [Internet]. 2023 [citado 2023 Dec 20]; 23(1):303. Disponible en: https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-023-02567-5
3. Andrade HB, Ferreira da Silva IR, Sim JL, Mello-Neto JH, Theodoro PHN, Torres da Silva MS, et al. Central nervous system infection in the intensive care unit: Development and validation of a multi-parameter diagnostic prediction tool to identify suspected patients. PLoS One [Internet]. 2021 [citado 2023 Dec 20]; 29;16(11):e0260551. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629274/pdf/pone.0260551.pdf
4. Saleem M, Syed Khaja AS, Hossain A, Alenazi F, Said KB, Moursi SA, et al. Catheter-Associated Urinary Tract Infection in Intensive Care Unit Patients at a Tertiary Care Hospital, Hail, Kingdom of Saudi Arabia. Diagnostics (Basel) [Internet]. 2022 [citado 2023 Dec 20]; 12(7):1695. Disponible en: https://www.mdpi.com/2075-4418/12/7/1695
5. Saade A, Moratelli G, Dumas G, Mabrouki A, Tudesq JJ, Zafrani L, et al. Infectious events in patients with severe COVID-19: results of a cohort of patients with high prevalence of underlying immune defect. Ann Intensive Care [Internet] 2021 [citado 2023 Dec 20]; 11: 83. Disponible en: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-021-00873-x#citeas
6. National Healthcare Safety Network. CDC/NHSN Surveillance Definitions for Specific Types of Infections. NHSN; 2021. [acceso: 20/12/2023]. Disponible en: https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf
7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med [Internet]. 1985 [citado 2023 Dec 20]; 13(10):818-29. Disponible en: https://www.researchgate.net/publication/19234189_APACHE_II_a_severity_of_disease_classification_system
8. Vincent JL, Ferreira F, Moreno R. Scoring systems for assessing organ dysfunction and survival. Crit Care Clin [Internet]. 2000 [citado 2023 Dec 20]; 16(2):353-66. Disponible en: https://www.criticalcare.theclinics.com/article/S0749-0704(05)70114-7/fulltext
9. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use innovative therapies in sepsis. The ACCP/SCCM Consensus Conference of Chest Physicians/Society of Critical Care Medicine Chest [Internet]. 1992 [citado 2023 Dec 20]; 101(6):1644-55. Disponible en: https://journal.chestnet.org/article/S0012-3692(16)38415-X/fulltext
10. Singer M, Deutschman C, Seymour CW,Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). JAMA [Internet].2016 [citado 2023 Dec 20]; 315(8):801-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968574/pdf/nihms794087.pdf
11. Protocolo de actuación nacional para la COVD-19. Versión. 1.5. julio 2020. [acceso: 20/12/2023]. Disponible en: https:// http://media.cubadebate.cu/wp-content/uploads/2020/08/VERSION-5-DEL-PROTOCOLO-PARA-PUBLICAR-13-DE-AGOSTO-2020_compressed.pdf
12. Westphal GA, Pereira AB, Fachin SM, Barreto ACC, Bornschein ACGJ, Caldeira Filho M, et al. Characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis. Rev Bras Ter Intensiva [Internet]. 2019 [citado 2023 Dec 20]; 31(1):71-78. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443308/pdf/rbti-31-01-0071.pdf
13. Hantrakun V, Somayaji R, Teparrukkul P, Boonsri C, Rudd K, Day NPJ, et al. Clinical epidemiology and outcomes of community acquired infection and sepsis among hospitalized patients in a resource limited setting in Northeast Thailand: A prospective observational study (Ubon-sepsis). PLoS ONE [Internet]. 2018 [citado 2022 Dec 20]; 13(9): e0204509. Disponible en: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0204509&type=printable
14. González JC, Cabrera JO, Vázquez YE, Arias A, Sánchez SA. Características y factores pronósticos de pacientes graves con infecciones adquiridas en la comunidad. Revista Cubana de Medicina Militar [Internet]. 2022 [citado 2023 14 Mar]; 51 (4) Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2229
15. Abdo A, Castellanos R. Incidencia de infecciones relacionadas con el cuidado sanitario en unidades de cuidados intensivos en Cuba: año 2015 e informe de tendencias del primer quinquenio. Investigaciones Medicoquirúrgicas [Internet].2017 [citado 2023 Dec 20]; 9 (1): [aprox. 28 p.]. Disponible en: http://www.revcimeq.sld.cu/index.php/imq/article/view/374
16. Elbakkoush AA, Khaleel A, Mohamed, ANA. Pathway analysis of sepsis-induced changes gene expression. Egypt J Med Hum Genet [Internet].2022 [citado 22 Dec 2023]; 23: 142 Disponible en: https://doi.org/10.1186/s43042-022-00352-3
17. Park DW, Chun BC, Kim JM, Sohn JW, Peck KR, Kim YS, Choi YH,et al. Epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock: a prospective observational study in 12 university hospitals in Korea. J Korean Med Sci [Internet]. 2012 [citado 22 Dec 2023]; 27(11):1308-14. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492663/pdf/jkms-27-1308.pdf
18. Jarczack D, Kluge S, Nierthaus. Sepsis-pathophysiology and Therapeutic Concepts. Front Med. [Internet]. 2021 [citado 22 Dec 2023]; 8:32. Disponible en: https://www.frontiersin.org/articles/10.3389/fmed.2021.628302/full
19. Blot S, Antonelli M, Arvaniti K, Blot K, Creagh-Brown B, de Lange D, et al. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project. Intensive Care Med [Internet]. 2019 [citado 2023 Dec 20]; 45(12):1703-17.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863788/pdf/134_2019_Article_5819.pdf
20. Vidal A, Santos L. Comorbidities impact on the prognosis of severe acute community-acquired pneumonia. Porto Biomed J [Internet]. 2019 [citado 22 Dec 2023]; 2(6):265-272. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806761/
21. Blot S, Antonelli M, Arvaniti K, Blot K, Creagh-Brown B, de Lange D, et al. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project. Intensive Care Med [Internet]. 2019 [citado 2023 Dec 20]; 45(12):1703-17.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863788/pdf/134_2019_Article_5819.pdf
22. Chen Y, Hu Y, Zhang J, Shen Y, Huang J, Yin J, et al. Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study. BMC Anesthesiol [Internet]. 2019 [citado 2023 Dec 20]; 19(1):185. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800505/pdf/12871_2019_Article_849.pdf
23. Boeddha NP, Schlapbach LJ, Driessen GJ, Herberg JA, Rivero-Calle I, Cebey-López M et al. Mortality and morbidity in community-acquired sepsis in European pediatric intensive care units: a prospective cohort study from the European Childhood Life-threatening Infectious Disease Study (EUCLIDS). Crit Care [Internet]. 2018 [citado 22 Dec 2023] 31; 22(1):143. Disponible en: https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2052-7
24. Jarczack D, Kluge S, Nierthaus. Sepsis-pathophysiology and Therapeutic Concepts. Front Med. [Internet]. 2021 [citado 22 Dec 2023]; 8:32. Disponible en: https://www.frontiersin.org/articles/10.3389/fmed.2021.628302/full
25. Evans L, Rhodes A, Alhazzan W, Antonelli M, Coopersmith CM, French C, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit C Med [Internet]. 2021 [citado 22 Dec 2023]; 49 (1): E1063. Disponible en: https://doi.org/10.1097/CCM.0000000000005337
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