Institutional Risk Factors Associated With Healthcare-Associated Infections in Brazilian ICUs: A Nested Cohort Within the IMPACTO-MR Platform
Authors' conclusion
Processes-of-care and ICU structure measures are associated with the burden of VAP and CLABSI in LMICs.
Study context
- Population
- Patients admitted to 50 Brazilian ICUs, September 2019 to December 2021, exposed to ≥2 days of invasive mechanical ventilation (MV) or central venous catheter (CVC)75,164 ICU admissions
- Exposure
- Institutional risk factors for ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI) rates
- Outcome
- VAP and CLABSI incidence rates and hospital-level variability
Methodological detailsmulticenter, nested cohort within the IMPACTO-MR platform, prospective individual patient data, cross-sectional hospital-level data
- Multicenter
- Nested cohort within the IMPACTO-MR platform
- Prospective individual patient data
- Cross-sectional hospital-level data
Main finding
As reported in the abstract
- VAP incidence rate per 1,000 MV-days
- 6.03 (19,108 at-risk patients, 244,059 MV-days; 95% CI 5.73-6.35)
- CLABSI incidence rate per 1,000 CVC-days
- 1.63 (26,560 patients, 375,078 CVC-days; 95% CI 1.51-1.77)
- Median rate ratio of hospital random-effects, VAP
- 4.39 (95% CI 2.72-6.06)
- Median rate ratio of hospital random-effects, CLABSI
- 3.53 (95% CI 2.30-4.76)
- Between-hospital variability explained by hospital-level fixed effects, VAP
- 39.9% (95% CI 33.6-46.1%)
- Between-hospital variability explained by hospital-level fixed effects, CLABSI
- 44.7% (95% CI 35.0-54.5%)
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Institutional Risk Factors Associated With Healthcare-Associated Infections in Brazilian ICUs: A Nested Cohort Within the IMPACTO-MR Platform. Crit Care Med. Published 24 September 2025. doi:10.
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