Risk factors associated with healthcare-associated infections (HAIs) in ICU patients of maternal and childcare units

Abstract

The objective of this study was to determine the risk factors associated with healthcare-associated infections (HAIs) in patients admitted to the Intensive Care Units (ICUs) of Bertha Calderón Roque Hospital and Manuel de Jesús Rivera Children’s Hospital, in Managua, Nicaragua, between 2020 and 2023. An analytical, observational, retrospective, case-control study was conducted with a sample of 342 patients (121 cases and 221 controls), selected through probabilistic sampling. Data were obtained from clinical records and analyzed using SPSS software, applying odds ratios, chi-square tests, and 95% confidence intervals. Results showed a predominance of the 0–5-year age group, female sex, and urban origin. Statistically significant risk factors included personal pathological history, family history of diabetes mellitus, hospital referral, and the use of central venous catheter, endotracheal tube, and Foley catheter. Protective factors identified were ICU stay of less than one week, clinical classification, use of a single invasive device, use of a cannula, and antibiotic monotherapy. The most frequent infection was bloodstream infection associated with central venous catheter (CVC-BSI), and the predominant etiological agents were Staphylococcus aureus and Escherichia coli, with a low rate of antimicrobial resistance (4.1%). It is concluded that there are significant clinical and procedural factors associated with the development of HAIs, highlighting the need to strengthen prevention and surveillance strategies in critical care settings.