Evidence map›Paper›PMID 39754200›Full record

ArticleCritical care (London, England)2025

Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort.

Bruno Martins Tomazini, Bruno Adler Maccagnan Pinheiro Besen, Renato Hideo Nakagawa Santos, Antonio Paulo Nassar, Thabata Silva Veiga, Viviane Bezerra Campos, Samira Martins Tokunaga, Elton Sousa Santos, Leticia Galvão Barbante, Renato da Costa Maia and 22 more

Abstract readMulticenter Study
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
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

32 authors.

Bruno Martins TomaziniHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil. btomazini@hcor.com.br.ORCID http://orcid.org/0000-0001-6763-6132
Bruno Adler Maccagnan Pinheiro BesenDiretoria de compromisso social, Hospital Sírio-Libanês, São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0002-3516-9696
Renato Hideo Nakagawa SantosHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0000-0002-0650-212X
Antonio Paulo NassarBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0002-0522-7445
Thabata Silva VeigaHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0009-0009-4043-1992
Viviane Bezerra CamposHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.
Samira Martins TokunagaHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0000-0003-3350-6481
Elton Sousa SantosHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0009-0004-4344-8857
Leticia Galvão BarbanteHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0009-0007-7578-0063
Renato da Costa MaiaHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0009-0000-6941-0065
Flavia Cristina Soares KojimaHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0009-0003-0641-671X
Ligia Nasi LaranjeiraHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0000-0002-1767-5261
Leandro Utino TaniguchiBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0003-4384-0408
Roberta Muriel Longo RoepkeBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0003-2214-5166
Cristiano Augusto FrankeHospital de Pronto Socorro de Porto Alegre, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0002-3418-232X
Luciana Coelho SanchesHospital de Amor, Barretos, SP, Brazil.
Livia Maria Garcia MelroHospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0001-8605-8745
Israel Silva MaiaHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0000-0003-3467-5287
Vicente Cés de Souza DantasHospital Naval Marcílio Dias, Rio de Janeiro, RJ, Brazil.ORCID http://orcid.org/0000-0002-1865-1704
Rodrigo Cruvinel FigueiredoHospital Maternidade São José, Colatina, MG, Brazil.
Meton Soares de Alencar FilhoHospital Maternidade São Vicente de Paulo, Barbalha, CE, Brazil.ORCID http://orcid.org/0000-0001-6281-9917
Vivian Menezes IrineuHospital Leo Orsi, Itapetininga, SP, Brazil.ORCID http://orcid.org/0000-0003-4024-0271
Wilson José LovatoHospital das Clínicas de Ribeirão Preto da Faculdade de Medicina da Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Cassio Luis ZandonaiHospital Nereu Ramos, Florianópolis, SC, Brazil.ORCID http://orcid.org/0009-0002-7855-1868
Flávia Ribeiro MachadoBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0002-2356-4867
Beatriz ArnsHospital Moinhos de Vento, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0002-4464-9763
Giovanna MarsolaHospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
Viviane Cordeiro VeigaBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0002-0287-3601
Adriano José PereiraBrazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil.ORCID http://orcid.org/0000-0002-9467-6516
Alexandre Biasi CavalcantiHCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.ORCID http://orcid.org/0000-0003-2798-6263
IMPACTO-MR investigators (2019 - 2023)
BRICNet

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimited data is available to evaluate the burden of device associated healthcare infections (HAI) [central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP)] in low and-middle-income countries. Our aim is to investigate the population attributable mortality fraction and the absolute mortality difference of HAI in a broad population of critically ill patients from Brazil.

methodsMulticenter cohort study from September 2019 to December 2023 with prospective individual patient data collection. VAP, CLABSI, and CAUTI were diagnosed by each center in accordance with Brazilian regulatory agency guidance. If a patient fulfilled all diagnostic criteria, he was deemed to have Confirmed HAI. An adjusted disability multistate model was used to evaluate the population attributable in-hospital mortality fraction (PAF) and the absolute in-hospital mortality difference (AMD).

resultsA total of 128,247 patients were included. 4066 (3.2%) distinct patients had at least one diagnosis of HAI (1493 CLABSI, 433 CAUTI, 2742 VAP, and 435 patients with more than one HAI) during the ICU stay. The PAF was 3.89% (95% CI 3.68-4.11%) for HAI, 2.16% (2.05-2.33%) for VAP, 1.2% (1.08-1.32%) for CLABSI, 0.11% (0.07-0.16%) for CAUTI, and 0.33% (0.26-0.4%) for ≥ 2 HAI. The AMD for HAI was 33.69% (95% CI 32.27-35.33%), 29.01% (27.15-30.98%) for VAP, 31.64% (29.3-34.81%) for CLABSI, 9.94% (3.88-15.54%) for CAUTI and 35.6% (28.93-42.99%) for ≥ 2 HAI.

conclusionsDevice-associated HAI significantly contribute to hospital mortality and impose a high excess risk of death for critically ill patients.

Indexed as

Catheter-Related InfectionsCross InfectionIntensive Care UnitsAdultAgedBrazilCohort StudiesFemaleHospital MortalityHumansMaleMiddle AgedPneumonia, Ventilator-AssociatedProspective StudiesUrinary Tract InfectionsAttributable mortalityBloodstream infectionHealthcare associated infectionIntensive care unitVentilator-associated pneumonia

Identifiers

PMID39754200
PMCPMC11699823

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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.