Infections related to invasive devices in the ICU: evidence-based strategies for reducing mortality and hospital costs
DOI:
https://doi.org/10.55892/jrg.v9i20.3401Keywords:
Hospital infection, Intensive care unit, Invasive devices, Patient safety, Antimicrobial resistanceAbstract
Healthcare-associated infections related to the use of invasive devices remain a major challenge in intensive care units, being associated with increased hospital mortality, prolonged hospitalization, antimicrobial resistance, and higher healthcare costs. Among the main infections are ventilator-associated pneumonia, central line-associated bloodstream infection, and catheter-associated urinary tract infection. This study aimed to critically analyze the scientific evidence regarding infections related to invasive devices in intensive care units and evidence-based strategies focused on reducing mortality and hospital costs. This is an integrative literature review with a qualitative and descriptive-analytical approach, based on the methodological framework proposed by Whittemore and Knafl. The bibliographic search was conducted between January and April 2026 in the PubMed/MEDLINE, Scopus, Web of Science, and ScienceDirect databases, using descriptors related to healthcare-associated infections, intensive care, invasive devices, infection prevention, and antimicrobial resistance. The final sample consisted of eight studies published between 2018 and 2025. The findings demonstrated an association between device-related infections and increased mortality, prolonged hospital stay, greater use of antimicrobials, and frequent occurrence of multidrug-resistant microorganisms, especially Acinetobacter baumannii, Klebsiella spp., Pseudomonas aeruginosa, and Escherichia coli. The most frequently described preventive strategies included care bundles, hand hygiene, standardized protocols for insertion and maintenance of invasive devices, active epidemiological surveillance, antimicrobial stewardship, and chlorhexidine decolonization. It is concluded that the implementation of structured preventive measures and continuous surveillance is associated with reduced rates of healthcare-associated infections, shorter hospital stays, and improved clinical outcomes in critically ill patients.
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References
BEHERA, Aruna Rani; JENA, Swetalina; SETHI, Rajesh Kumar. Device associated hospital acquired infections in a tertiary care hospital in Western Odisha. National Journal of Laboratory Medicine, v. 11, n. 1, p. MO06-MO10, 2022. DOI: https://doi.org/10.7860/NJLM/2022/50353.2562.
DRAY, Sandrine; FOREL, Jean-Marie; PAPAZIAN, Laurent. What’s new in the prevention of healthcare-associated infections using chlorhexidine gluconate-impregnated washcloths. Intensive Care Medicine, v. 44, p. 2278-2281, 2018. DOI: https://doi.org/10.1007/s00134-018-5354-y.
EDWARDSON, Stuart; CAIRNS, Chris. Nosocomial infections in the ICU. Anaesthesia & Intensive Care Medicine, v. 20, n. 1, p. 14-18, 2019. DOI: https://doi.org/10.1016/j.mpaic.2018.11.004.
GADE, Neeta et al. Promoting patient safety: exploring device-associated healthcare infections and antimicrobial susceptibility pattern in a multidisciplinary intensive care units. Cureus, v. 15, n. 12, e50232, 2023. DOI: https://doi.org/10.7759/cureus.50232.
LOHIYA, Ruchita; DEOTALE, Vijayshri. Surveillance of health-care associated infections in an intensive care unit at a tertiary care hospital in Central India. GMS Hygiene and Infection Control, v. 18, p. Doc12, 2023. DOI: https://doi.org/10.3205/dgkh000454.
MICHELS JUNIOR, Vilto et al. Incidence of infections associated with the use of invasive devices in an ICU after application of the Improvement Science Methodology. Revista Ciências em Saúde, v. 13, n. 3, p. 66-73, 2023. DOI: https://doi.org/10.21876/rcshci.v13i3.1444.
PHULPOTO, Abdul Hayee et al. Prospective study on the incidence of hospital acquired infections in intensive care unit. Pakistan Journal of Health Sciences, v. 6, n. 1, p. 124-129, 2025. DOI: https://doi.org/10.54393/pjhs.v6i1.2611.
ROSENTHAL, Victor Daniel et al. The impact of healthcare-associated infections on mortality in ICU: a prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East. American Journal of Infection Control, v. 51, n. 6, p. 675-682, 2023. DOI: https://doi.org/10.1016/j.ajic.2022.08.024.
WHITTEMORE, Robin; KNAFL, Kathleen. The integrative review: updated methodology. Journal of Advanced Nursing, v. 52, n. 5, p. 546-553, 2005. DOI: https://doi.org/10.1111/j.1365-2648.2005.03621.x.
