{"doi":"10.1017/ash.2023.409","title":"Impact of the Severe acute respiratory syndrome coronavirus 2 pandemic on mortality associated with healthcare-associated infections","abstract":"Abstract Objective: To determine the relationship between severe acute respiratory syndrome coronavirus 2 infection, hospital-acquired infections (HAIs), and mortality. Design: Retrospective cohort. Setting: Three St. Louis, MO hospitals. Patients: Adults admitted ≥48 hours from January 1, 2017 to August 31, 2020. Methods: Hospital-acquired infections were defined as those occurring ≥48 hours after admission and were based on positive urine, respiratory, and blood cultures. Poisson interrupted time series compared mortality trajectory before (beginning January 1, 2017) and during the first 6 months of the pandemic. Multivariable logistic regression models were fitted to identify risk factors for mortality in patients with an HAI before and during the pandemic. A time-to-event analysis considered time to death and discharge by fitting Cox proportional hazards models. Results: Among 6,447 admissions with subsequent HAIs, patients were predominantly White (67.9%), with more females (50.9% vs 46.1%, P = .02), having slightly lower body mass index (28 vs 29, P = .001), and more having private insurance (50.6% vs 45.7%, P = .01) in the pre-pandemic period. In the pre-pandemic era, there were 1,000 (17.6%) patient deaths, whereas there were 160 deaths (21.3%, P = .01) during the pandemic. A total of 53 (42.1%) coronavirus disease 2019 (COVID-19) patients died having an HAI. Age and comorbidities increased the risk of death in patients with COVID-19 and an HAI. During the pandemic, Black patients with an HAI and COVID-19 were more likely to die than White patients with an HAI and COVID-19. Conclusions: In three Midwestern hospitals, patients with concurrent HAIs and COVID-19 were more likely to die if they were Black, elderly, and had certain chronic comorbidities.","journal":"Antimicrobial Stewardship & Healthcare Epidemiology","year":2023,"id":378945,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5826,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":489803,"name":"Katelin B. Nickel","orcid":"0000-0003-4116-512X","position":1,"is_corresponding":false},{"id":388574,"name":"John M. Sahrmann","orcid":"0000-0001-6000-0908","position":2,"is_corresponding":false},{"id":712852,"name":"Dustin Stwalley","orcid":"0000-0002-6427-0590","position":3,"is_corresponding":false},{"id":396876,"name":"Erik R. Dubberke","orcid":"0000-0003-3779-2796","position":4,"is_corresponding":false},{"id":936207,"name":"Kathleen McMullen","orcid":"0000-0002-0833-1467","position":5,"is_corresponding":false},{"id":600761,"name":"Jonas Marschall","orcid":"0000-0002-0052-3210","position":6,"is_corresponding":false},{"id":385409,"name":"Margaret A. Olsen","orcid":"0000-0001-7070-9320","position":7,"is_corresponding":false},{"id":255060,"name":"Jennie H. Kwon","orcid":"0000-0002-7824-6276","position":8,"is_corresponding":false},{"id":420202,"name":"Jason P. Burnham","orcid":"0000-0002-4777-3006","position":9,"is_corresponding":false},{"id":863546,"name":"Andrew Atkinson","orcid":"0000-0001-5834-8315","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T01:16:48.594070Z","pmid":"37771748","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}