Evidence map›Paper›PMID 36283138›Full record

ArticleClinics (Sao Paulo, Brazil)2022

The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19.

Viviane de Macedo, Gabriela de Souza Dos Santos, Rodolff Nunes da Silva, Caio Nogara de Menezes Couto, Camila Bastos, Eloize Viecelli, Marina do Nascimento Mateus, Maria Esther Graf, Raquel Bernardelli Gonçalves, Márcia Aparecida da Silva and 5 more

Open access · goldAbstract read
In one paragraph

Article in Clinics (Sao Paulo, Brazil), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Evaluation of Infections Caused by Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2025
    Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Viviane de MacedoHospital Infection Control and Epidemiology Center, Santa Casa de Curitiba, Curitiba, PR, Brazil; Faculdade de Medicina, Universidade Positivo, Curitiba, PR, Brazil; Department of Infectious Diseases, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: vioakmac@gmail.com.
Gabriela de Souza Dos SantosHospital Infection Control and Epidemiology Center, Rehabilitation Hospital, Curitiba, PR, Brazil.
Rodolff Nunes da SilvaInfection Control Program, Hospital de Clínicas, Curitiba, PR, Brazil.
Caio Nogara de Menezes CoutoFaculdade de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
Camila BastosFaculdade de Medicina, Universidade Positivo, Curitiba, PR, Brazil.
Eloize ViecelliFaculdade de Medicina, Universidade Positivo, Curitiba, PR, Brazil.
Marina do Nascimento MateusFaculdade de Medicina, Universidade Positivo, Curitiba, PR, Brazil.
Maria Esther GrafHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Raquel Bernardelli GonçalvesHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Márcia Aparecida da SilvaHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Patricia Dal Bem BernardiniHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Roberta Serra Pereira GrandoHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Viviane Pavanelo BoaventuraHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Helki Simone Rodrigues PereiraHospital Infection Control and Epidemiology Center, Hospital do Trabalhador, Curitiba, PR, Brazil.
Anna S LevinDepartment of Infectious Diseases, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Universidade Positivo · BRUniversidade de São Paulo · BRHospital de Clínicas Universidade Federal do Paraná · BRPontifícia Universidade Católica do Paraná · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU).

methodsThis is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done.

resultsSixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009).

conclusionsMale gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential.

Indexed as

COVID-19Cross InfectionGram-Negative Bacterial InfectionsAdolescentAdultAnti-Bacterial AgentsCase-Control StudiesCritical IllnessDrug Resistance, Multiple, BacterialGram-Negative BacteriaHumansIntensive Care UnitsMaleRisk FactorsAnti-Bacterial AgentsAntimicrobial resistanceCOVID-19Gram-negative bacteriaHealth FacilityIntensive Care Unit

Identifiers

PMID36283138
PMCPMC9576217
OpenAlexW4306405780

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.