Nosocomial infections among critically ill COVID-19 patients in Australia

Abstract Purpose To determine the frequency of nosocomial infections including hospital-acquired pneumonia (HAP) and bloodstream infection (BSI), among critically ill patients with COVID-19 infection in Australian ICUs and to evaluate associations with mortality and length of stay (LOS). Methods The effect of nosocomial infections on hospital mortality was evaluated using hierarchical logistic regression models to adjust for illness severity and mechanical ventilation. Results There were 490 patients admitted to 55 ICUs during the study period. Adjusted odds ratio (OR) for hospital mortality was 1.61 (95% confidence interval (CI) 0.61-4.27, p=0.3) when considering BSI, and 1.76 (95% CI 0.73-4.21, p=0.2) for HAP. The average adjusted ICU LOS was significantly longer for patients with BSI (geometric mean 9.0 days vs 6.3 days, p=0.04) and HAP (geometric mean 13.9 days vs 6.0 days p Conclusion Nosocomial infection rates among patients with COVID-19 were low and their development was associated with a significantly longer ICU LOS.