Healthcare-associated infections (HAIs) represent important adverse events in hospitals, especially in intensive care units (ICUs), where the use of invasive devices is common. Active surveillance of these infections allows identification of patterns, guidance of preventive measures, and reduction of complications. This study analyzes the trend in the incidence density of three priority infections in adult ICUs in Brazil between 2013 and 2022: urinary tract infection associated with indwelling urinary catheter, ventilator-associated pneumonia, and bloodstream infection related to central venous catheter, based on data from the Agência Nacional de Vigilância Sanitária (ANVISA). Analysis of these time series contributes to evaluating the impact of patient safety policies. This is an ecological, descriptive, retrospective study using aggregated public-domain data. Information extracted from ANVISA Patient Safety Reports between 2013 and 2022 was used. The variables analyzed were incidence densities (infections per 1,000 device-days) of: ventilator-associated pneumonia (VAP); central venous catheter-associated bloodstream infection (CLABSI); and urinary tract infection associated with indwelling urinary catheter (CAUTI). Data were organized by year, including only Brazilian adult ICUs. A descriptive analysis of temporal trends in rates by type of HAI was performed. The incidence density of CLABSI showed a continuous downward trend over the analyzed period, decreasing from 5.4 infections/1,000 catheter-days in 2013 to 2.7 in 2022. VAP also demonstrated a significant reduction, decreasing from 16.8 to 10.2 infections/1,000 ventilator-days. CAUTI, in turn, showed a decline until 2019, reaching 3.1 infections/1,000 catheter-days, but increased in 2020 and 2021, possibly related to the COVID-19 pandemic, with subsequent stabilization in 2022. Between 2013 and 2022, VAP and CLABSI rates in Brazilian ICUs showed a downward trend, attributed to the implementation of preventive bundles, greater adherence to hand hygiene, and patient safety practices. In contrast, fluctuations in CAUTI during the pandemic highlighted the impact of health crises on quality of care. The study reinforces the importance of surveillance and continuous strategies for HAI control.
Stocki et al. (Sun,) studied this question.