Mr Huangyi Yang1, Dr Wenzhi Huang1, Dr Yi Chen1, Dr Ji Lin1, Ms Yalan Peng1, Ms Na Lei1, Ms Qinghui Zeng1, Dr Fu QIAO1
1Department Of Infection Control, West China Hospital, Sichuan University, Chengdu, P. R. China, Chengdu, China
Biography:
MD, Associate Chief Technologist, Deputy Director, Department of Infection Control. Published 60 peer-reviewed articles as first or corresponding author and served as chief editor for 5 monographs on healthcare-associated infection prevention and control. Additionally, I hold 2 invention patents in related fields. International Ambassador Program Winner of SHEA in 2016.
Abstract:
Objective
To evaluate the prognostic impact of healthcare-associated infections caused by carbapenem-resistant organism (CRO) in influenza patients and identify additional prognostic determinants.
Methods
A retrospective cohort study design was conducted at West China Hospital, Sichuan University. Patients hospitalized with influenza from 2013 to 2023 were enrolled. The exposed group comprised patients with healthcare-associated CRO co-infections, while the non-exposed group included those without CRO co-infections. Prognostic outcomes (mortality and poor prognosis) were analyzed using Kaplan-Meier survival curves and Cox proportional hazards regression models adjusted for age, comorbidities, and invasive interventions.
Results
Among 1,546 influenza patients, the overall mortality rate was 0.71% (11/1,546), and the poor prognosis rate was 5.11% (79/1,546). The exposed group (n=130) exhibited a non-significantly higher mortality rate (2.31% vs. 0.56%, χ²=0.602, P=0.438) but a significantly elevated poor prognosis rate (16.15% vs. 4.10%, χ²=7.412, P=0.008) compared to the non-exposed group (n=1,416). Multivariate analysis confirmed CRO co-infection as an independent risk factor for poor prognosis (HR=1.98, 95% CI [1.199–3.303], P=0.008), though not for mortality (HR=1.70, 95% CI [0.279–4.754], P=0.844). Subgroup analysis identified carbapenem-resistant Acinetobacter baumannii (CRAB) as a key driver of poor prognosis (HR=2.07, 95% CI [1.140–3.307], P=0.001).
Conclusion
CRO co-infection independently predicts poor prognosis in influenza patients, underscoring the need for stringent infection control measures and timely clinical interventions targeting these pathogens, especially CRAB. Multicenter studies are warranted to validate these findings and refine risk stratification protocols.