Abstract
OBJECTIVE: To analyze the demographic and microbiological characteristics and clinical outcomes of people with healthcare-associated infections (HAI) admitted to an intensive care unit (ICU) in Mato Grosso state, Brazil, between 2018 and 2021, comparing the pre-COVID-19 and the COVID-19 pandemic periods. METHODS: This is a descriptive and longitudinal study with secondary data on people diagnosed with HAI. HAI, isolated microorganisms, sensitivity profile, comorbidities, clinical outcomes and sociodemographic data were analyzed. RESULTS: Between 2018 and 2021, 384 people were admitted to the ICU. There were 218 HAI episodes in 179 of them. In the pre-pandemic period (2018-2019), 95 episodes were recorded in 73 people, predominantly associated with: mechanical ventilation (48.4%), male sex (65.8%), the 40-64 age group (43.8%), those of mixed race (80.8%) and hypertensive (45.2%), with 19.2% recovery and 79.4% death. During the pandemic period (2020-2021), 123 episodes occurred in 106 people, with a predominance of primary bloodstream infection (43.1%) in females (50.9%), in the 17-39 age group (40.6%), those of mixed race (65.1%), and with hypertension (35.8%), with a 62.3% cure rate and a 37.7% death rate. There was persistently high overall carbapenem resistance in both periods. Between 2018 and 2019, Klebsiella pneumoniae (81.2%) and Acinetobacter spp. (78.6%) predominated. Between 2020 and 2021, resistance was found for Klebsiella pneumoniae (73.9%) and Acinetobacter spp. (80.0%). CONCLUSION: HAI in the ICU remained severe and associated with persistent antimicrobial resistance, mainly to multidrug-resistant Klebsiella pneumoniae. This emphasized the urgency of more effective prevention and control strategies in the hospital setting.