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Burden and impact of hospital-acquired infections in patients with chronic lung disease

Evangelos Kritsotakis, Flora Kontopidou, Eirini Astrinaki, Maria Roumbelaki, Georgios-Michael Gourgoulis, Eleni Ioannidou, Emmanouil Bolikas, Achilleas Gikas
European Respiratory Journal 2016 48: PA4912; DOI: 10.1183/13993003.congress-2016.PA4912
Evangelos Kritsotakis
1School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Flora Kontopidou
2Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
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Eirini Astrinaki
3Infection Control Unit, University Hospital of Heraklion, Heraklion, Greece
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Maria Roumbelaki
4Department of Nursing, Technological Educational Institute of Crete, Heraklion, Greece
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Georgios-Michael Gourgoulis
2Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
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Eleni Ioannidou
5Department of Internal Medicine, Rethymnon General Hospital, Rethymnon, Greece
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Emmanouil Bolikas
6Infection Control Unit, Venizeleion General Hospital, Heraklion, Greece
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Achilleas Gikas
3Infection Control Unit, University Hospital of Heraklion, Heraklion, Greece
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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.

  • Infections
  • Epidemiology
  • Chronic disease
  • Copyright ©the authors 2016
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Burden and impact of hospital-acquired infections in patients with chronic lung disease
Evangelos Kritsotakis, Flora Kontopidou, Eirini Astrinaki, Maria Roumbelaki, Georgios-Michael Gourgoulis, Eleni Ioannidou, Emmanouil Bolikas, Achilleas Gikas
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4912; DOI: 10.1183/13993003.congress-2016.PA4912

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Burden and impact of hospital-acquired infections in patients with chronic lung disease
Evangelos Kritsotakis, Flora Kontopidou, Eirini Astrinaki, Maria Roumbelaki, Georgios-Michael Gourgoulis, Eleni Ioannidou, Emmanouil Bolikas, Achilleas Gikas
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4912; DOI: 10.1183/13993003.congress-2016.PA4912
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