Healthcare associated infections among COVID-19 patients; Incidence, mortality, and risk factors

Morsi, Samar Saaed; Alfadhalh, Kholoud Mohammed; Hamza, Wafaa Seddik

doi:10.21608/ejcm.2025.338715.1346

Healthcare associated infections among COVID-19 patients; Incidence, mortality, and risk factors

Document Type : Original Article

Authors

¹ Department of Microbiology and Immunology, faculty of Medicine, Zagazig university, Zagazig,Egypt

² Infection Control Directorate,Ministry of Health, Kuwait

³ Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt

10.21608/ejcm.2025.338715.1346

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.

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