{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T00:23:54Z","timestamp":1793579034580,"version":"4.5.0"},"reference-count":31,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["COVID-2020-12371675"],"award-info":[{"award-number":["COVID-2020-12371675"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004702","name":"Baxter International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004702","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal.chestnet.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Chest"],"published-print":{"date-parts":[[2021,8]]},"DOI":"10.1016\/j.chest.2021.04.002","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T20:06:40Z","timestamp":1618949200000},"page":"454-465","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":305,"title":["Hospital-Acquired Infections in Critically Ill Patients With COVID-19"],"prefix":"10.1016","volume":"160","author":[{"given":"Giacomo","family":"Grasselli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Scaravilli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Mangioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigia","family":"Scudeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Alagna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bartoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Bellani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Biagioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bonfanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Bottino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Coloretti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore Lucio","family":"Cutuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"De Pascale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Ferlicca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Fior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Forastieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Franzetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Greco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"Guzzardella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Linguadoca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Meschiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Messina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaola","family":"Monti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Morelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Muscatello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Redaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Stefanini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Tonetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Antonelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Cecconi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Foti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Fumagalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Girardis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ranieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Viale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Raviglione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pesenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"16","key":"10.1016\/j.chest.2021.04.002_bib1","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1001\/jama.2020.5394","article-title":"Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"issue":"10","key":"10.1016\/j.chest.2021.04.002_bib2","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1001\/jamainternmed.2020.3539","article-title":"Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy","volume":"180","author":"Grasselli","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"16","key":"10.1016\/j.chest.2021.04.002_bib3","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1001\/jama.2020.4031","article-title":"Critical care utilization for the COVID-19 outbreak in Lombardy, Italy","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"issue":"10239","key":"10.1016\/j.chest.2021.04.002_bib4","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1016\/S0140-6736(20)31189-2","article-title":"Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study","volume":"395","author":"Cummings","year":"2020","journal-title":"Lancet"},{"issue":"7","key":"10.1016\/j.chest.2021.04.002_bib5","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s00134-020-06153-9","article-title":"Acute kidney injury in critically ill patients with COVID-19","volume":"46","author":"Gabarre","year":"2020","journal-title":"Intensive Care Med"},{"issue":"15","key":"10.1016\/j.chest.2021.04.002_bib6","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of immune response in patients with coronavirus. 2019 (COVID-19) in Wuhan, China","volume":"71","author":"Qin","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"8","key":"10.1016\/j.chest.2021.04.002_bib7","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1017\/ice.2020.126","article-title":"Nosocomial infection among patients with COVID-19: a retrospective data analysis of 918 cases from a single center in Wuhan, China","volume":"41","author":"He","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"10","key":"10.1016\/j.chest.2021.04.002_bib8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/eci.13319","article-title":"Bloodstream infections in critically ill patients with COVID-19","volume":"50","author":"Giacobbe","year":"2020","journal-title":"Eur J Clin Invest"},{"issue":"12","key":"10.1016\/j.chest.2021.04.002_bib9","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/j.cmi.2020.07.016","article-title":"Bacterial coinfection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis","volume":"26","author":"Langford","year":"2020","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"10.1016\/j.chest.2021.04.002_bib10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-02939-x","article-title":"Patients with COVID-19 in 19 ICUs in Wuhan, China: a cross-sectional study","volume":"24","author":"Yu","year":"2020","journal-title":"Crit Care"},{"issue":"5","key":"10.1016\/j.chest.2021.04.002_bib11","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/cid\/ciaa762","article-title":"Bacterial pneumonia in COVID-19 critically ill patients: a case series","volume":"72","author":"Dudoignon","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"1","key":"10.1016\/j.chest.2021.04.002_bib12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","article-title":"Incidence of coinfections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study","volume":"27","author":"Garcia-Vidal","year":"2021","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"10.1016\/j.chest.2021.04.002_bib13","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cmi.2020.10.021","article-title":"Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors","volume":"27","author":"Ripa","year":"2020","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"10.1016\/j.chest.2021.04.002_bib14","first-page":"151","article-title":"Risk factors and outcomes of hospitalized patients with severe coronavirus disease 2019 (COVID-19) and secondary bloodstream infections: a multicenter case-control study","volume":"53","author":"Bhatt","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"5","key":"10.1016\/j.chest.2021.04.002_bib15","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1007\/s00134-020-05980-0","article-title":"Ventilator-associated pneumonia in adults: a narrative review","volume":"46","author":"Papazian","year":"2020","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.chest.2021.04.002_bib16","doi-asserted-by":"crossref","unstructured":"Hanson KE, Caliendo AM, Arias CA, et al. Infectious Diseases Society of America guidelines on the diagnosis of coronavirus disease 2019 [published online ahead of print June 16, 2020]. Clin Infect Dis. https:\/\/doi.org\/10.1093\/cid\/ciaa760","DOI":"10.1093\/cid\/ciaa760"},{"issue":"3","key":"10.1016\/j.chest.2021.04.002_bib17","doi-asserted-by":"crossref","first-page":"1700582","DOI":"10.1183\/13993003.00582-2017","article-title":"International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia","volume":"50","author":"Torres","year":"2017","journal-title":"Eur Respir J"},{"issue":"11","key":"10.1016\/j.chest.2021.04.002_bib18","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1086\/648113","article-title":"IDSA guidelines for the diagnosis and management of intravascular catheter-related bloodstream infection","volume":"49","author":"Manian","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"5","key":"10.1016\/j.chest.2021.04.002_bib19","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1086\/596757","article-title":"Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America","volume":"48","author":"Pappas","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"5","key":"10.1016\/j.chest.2021.04.002_bib20","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1164\/rccm.201906-1185ST","article-title":"Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice: an official American Thoracic Society clinical practice guideline","volume":"200","author":"Hage","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"10.1016\/j.chest.2021.04.002_bib21","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med"},{"issue":"3","key":"10.1016\/j.chest.2021.04.002_bib22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin Microbiol Infect"},{"issue":"10223","key":"10.1016\/j.chest.2021.04.002_bib23","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"issue":"10229","key":"10.1016\/j.chest.2021.04.002_bib24","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"issue":"10223","key":"10.1016\/j.chest.2021.04.002_bib25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"issue":"24","key":"10.1016\/j.chest.2021.04.002_bib26","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1056\/NEJMc2010419","article-title":"Clinical characteristics of Covid-19 in New York City","volume":"382","author":"Goyal","year":"2020","journal-title":"N\u00a0Engl J Med"},{"issue":"21","key":"10.1016\/j.chest.2021.04.002_bib27","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1001\/jama.2009.1754","article-title":"International study of the prevalence and outcomes of infection in intensive care units","volume":"302","author":"Vincent","year":"2009","journal-title":"JAMA"},{"issue":"10","key":"10.1016\/j.chest.2021.04.002_bib28","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1097\/CCM.0000000000002652","article-title":"Nosocomial infections during extracorporeal membrane oxygenation","volume":"45","author":"Grasselli","year":"2017","journal-title":"Crit Care Med"},{"issue":"1","key":"10.1016\/j.chest.2021.04.002_bib29","first-page":"13","article-title":"Epidemiology of nosocomial infection in 125 Italian intensive care units","volume":"76","author":"Malacarne","year":"2010","journal-title":"Minerva Anestesiol"},{"issue":"2","key":"10.1016\/j.chest.2021.04.002_bib30","doi-asserted-by":"crossref","first-page":"116","DOI":"10.3390\/v11020116","article-title":"Characterization of host and bacterial contributions to lung barrier dysfunction following coinfection with 2009 pandemic influenza and methicillin resistant Staphylococcus aureus","volume":"11","author":"Nickol","year":"2019","journal-title":"Viruses"},{"issue":"9","key":"10.1016\/j.chest.2021.04.002_bib31","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/cid\/ciaa530","article-title":"Bacterial and fungal coinfection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing","volume":"71","author":"Rawson","year":"2020","journal-title":"Clin Infect Dis"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369221006796?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369221006796?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T08:36:48Z","timestamp":1757925408000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0012369221006796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["S0012369221006796"],"URL":"https:\/\/doi.org\/10.1016\/j.chest.2021.04.002","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Hospital-Acquired Infections in Critically Ill Patients With COVID-19","name":"articletitle","label":"Article Title"},{"value":"Chest","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.chest.2021.04.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}