Healthcare-associated infections in COVID-19 and non-COVID-19 patients during the SARS-CoV-2 pandemic in an Indonesian Referral Hospital

Gayatri Mauly PurwandariSchool of Tropical Medicine and Global Health Nagasaki University, Nagasaki, Japan; and Infection Prevention Control Committee, Universitas Indonesia Hospital, Depok, Indonesia

Satoshi KakiuchiInfection Control and Education Center, Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan

Masato TashiroInfection Control and Education Center, Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; and Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan

Dimas SetoDepartment of Microbiology, Faculty of Medicine Universitas Indonesia, Indonesia/Clinical Microbiology Medical Staff Group Universitas Indonesia Hospital, Jakarta & Depok, Indonesia

Agustin IndracahyaniDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa, USA

Irandi Putra PratomoDepartment of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia – Pulmonology and Respiratory Medicine Staff Group, Universitas Indonesia Hospital, Universitas Indonesia, Jakarta & Depok, Indonesia

Koichi IzumikawaSchool of Tropical Medicine and Global Health Nagasaki University, Nagasaki, Japan; 2Infection Prevention Control Committee, Universitas Indonesia Hospital, Depok, Indonesia; Infection Control and Education Center, Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; and Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan

Takeshi TanakaSchool of Tropical Medicine and Global Health Nagasaki University, Nagasaki, Japan; and Infection Control and Education Center, Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan

DOI:

https://doi.org/10.3396/ijic.v22.23869

Keywords:

Healthcare-Associated Infections, infection prevention and control (IPC), carbapenem resistance, COVID-19

Abstract

Background: Low- and middle-income countries (LMICs) face more challenges in overcoming healthcare-associated infections (HAIs) due to limited data surveillance, especially during the COVID-19 pandemic. We investigated the epidemiology and relationships between HAIs and COVID-19 status in a referral hospital in Indonesia.

Methods: A retrospective study was conducted at Universitas Indonesia Hospital from 2021 to 2022. HAI types were categorized into ventilator-associated event (VAE), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infections (CAUTIs). Data were collected from the inpatient ward, emergency department, and intensive care unit. The association among HAIs, COVID-19, and isolated bacteria was analyzed descriptively, and multivariate logistic regression for potential risk factors.

Results: We evaluated 255 patients who experienced HAIs, including 159 patients with COVID-19. The incidence of CLABSI was significantly associated with COVID-19 patients (P < 0.001), whereas the occurrence of VAE was significantly lower (P = 0.001). There was no significant association with CAUTI (P = 0.870). Acinetobacter baumannii was isolated as a common cause of HAIs (19%). Carbapenem resistance rates were high among A. baumannii (89.8%) and Pseudomonas aeruginosa (86.9%). Risk factors of CLABSI included COVID-19 status and chronic renal disease, while that of VAE included sex-male (aOR = 1.97).

Conclusions: CLABSI was significantly associated with the occurrence of HAIs in patients with COVID-19, while VAE was low, and CAUTI was not significantly impacted. In addition, the isolation rate of carbapenem-resistant bacteria was high. It highlights the urgent need to strengthen the infection prevention and control and antimicrobial stewardship (AMS) approaches through continuous education, monitoring, and enhanced surveillance efforts at the facility level.

How to Cite:

Purwandari, G. M., Kakiuchi , S., Tashiro, M., Seto, D., Indracahyani, A., Pratomo, I. P., … Tanaka, T. (2026). Healthcare-associated infections in COVID-19 and non-COVID-19 patients during the SARS-CoV-2 pandemic in an Indonesian Referral Hospital. International Journal of Infection Control, 22. https://doi.org/10.3396/ijic.v22.23869

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Copyright (c) 2026 Gayatri Mauly Purwandari, Satoshi Kakiuchi , Masato Tashiro, Dimas Seto, Agustin Indracahyani, Irandi Putra Pratomo, Koichi Izumikawa, Takeshi Tanaka

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