Incidence and Clinical Characteristics of Nosocomial Infections in COVID Intensive Care Unit

ABSTRACT

Introduction: Although there is limited data on the frequency of nosocomial infections in patients followed up in the intensive care unit due to COVID-19, the rate of empirical antibiotic use in these patients is quite high. In our study, it was planned to determine the frequency of nosocomial infections in patients hospitalized in intensive care units due to COVID-19, the pathogens isolated in nosocomial infections, and to investigate the characteristics of these infections. Materials and Methods: Our study is a retrospective study in which the records of 590 adult patients hospitalized in the COVID-19 intensive care unit and followed prospectively between April 1, 2020 and December 31, 2021 were examined. Results: In our study, nosocomial infection developed in 7.28% of patients hospitalized in the intensive care unit due to COVID-19, and mortality was 93% in patients who developed nosocomial infections. Of these infections, 67.44% were lower respiratory tract infections, 25.58% were bloodstream infections, and 6.97% were urinary tract infections. While the median number of toatl hospital stay was 20 days, the median time since admission to infection was 12 days. Infections often developed with a single microorganism, and the most frequently isolated microorganisms are A. baumannii and K. pneumoniae. Conclusion: Nosocomial infections that develop in patients followed in the intensive care unit due to COVID-19, are seen in approximately 7% of patients, but are mortal. In this patient group, regular microbiological follow-up and implementation of strict infection control measures especially for the prevention of ventilator-associated pneumonia;It is recommended to review the antibiotics frequently used in the follow-up and treatment of COVID-19 and to be selective in the decision to start empirical antibiotics in order to prevent the development of antimicrobial resistance.