Abstract
Background: Hospital-acquired infections (HAIs) affect 6 in 100 patients in acute-care hospitals in Europe, but their burden on patients admitted with chronic lung disease (CLD) is not well documented.
Aim: To assess the prevalence of HAIs and their impact on mortality 30 and 90 days after hospital admission in adult CLD patients.
Methods: Cross-sectional study in a stratified cluster sample of 37 hospitals in Greece, June 2012. CLD was recorded as documented chronic obstructive pulmonary disease, bronchiectasis, or any structural lung disease. HAIs were identified using the European Centre for Disease Prevention and Control criteria. A 3-month follow-up was performed to record patient outcome. Multiple Cox regression estimated the hazard ratio (HR) of death adjusting for important baseline predictors of mortality.
Results: 741 patients with CLD were identified: mean age 72±13 years, 68% men, in medical (64%) & surgical (21%) wards and intensive care units (11%). A total of 108 HAIs were recorded in 99 CLD-patients (weighted prevalence: 14.2%; 95% confidence interval (CI): 12.1-16.7%), including lower respiratory tract (57 cases; 53%), urinary tract (11 cases; 10%), bloodstream (10 cases; 9%) and other (30 cases; 28%) infections. Mortality rates at 30 and 90 days were 12% and 32% for patients with HAI and 5% and 8% for uninfected patients, respectively. Patients with HAI had an adjusted HR of 0.79 (95% CI: 0.47-1.35) and 1.31 (95% CI: 0.84-2.05) for death within 30 and 90 days, respectively, compared to those without HAI.
Conclusion: CLD patients carry a substantial HAI burden which is mainly, but not exclusively, due to lower respiratory tract infections. Long-term mortality risk is substantial.
- Copyright ©the authors 2016
