Risk factors associated with healthcare-associated infections in adult ICU patients

Abstract

The study aimed to  determine healthcare-associated infections (HAIs) in patients admitted to the Intensive Care Units of the Hospital Escuela Antonio Lenin Fonseca and the Hospital Escuela Roberto Calderón between 2020 and 2023. An analytical, observational, retrospective, case-control study with a cross-sectional design was conducted. A total of 121 cases and 221 controls were included, selected through probabilistic random sampling, meeting inclusion criteria based on hospital stays longer than 72 hours and complete medical records. Data were collected from clinical files and processed using SPSS, applying odds ratios (OR), 95% confidence intervals (CI), chi-square (χ²), and p-values. A significant association was found between HAIs and male sex (OR 1.64, p=0.0168), hospital referral, use of central venous catheter (OR 24.17), endotracheal tube (OR 16.85), and Foley catheter (OR 6.45). Protective factors included clinical classification, ICU stay <1 week, use of only one invasive device, peripheral catheter (bránula), and monotherapy antibiotic regimen. Central line-associated bloodstream infection (CLABSI) (52.9%) and ventilator-associated pneumonia (VAP) (26.5%) were the most prevalent HAIs. The main etiologic agents were Pseudomonas aeruginosa (26.4%) and Staphylococcus aureus (24.8%), with 33.9% showing antimicrobial resistance. The study concludes that there are significant sociodemographic, clinical, and microbiological factors associated with the development of HAIs, confirming the initial hypothesis and underscoring the importance of strengthening prevention and control strategies in ICU settings.