{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:31:53Z","timestamp":1777350713473,"version":"3.51.4"},"reference-count":30,"publisher":"Belitung Raya Foundation","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"This study was financed in part by the Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de\nPessoal de N\u00edvel Superior - Brasil (CAPES) - Finance Code 001","award":[""],"award-info":[{"award-number":[""]}]}],"content-domain":{"domain":["belitungraya.org"],"crossmark-restriction":true},"short-container-title":["Belitung Nurs J"],"abstract":"<jats:p>Background: Healthcare-associated infections (HAIs) in intensive care units (ICUs) are frequent and are associated with sepsis, antimicrobial resistance, and high mortality, reinforcing the need for early risk stratification at admission.\nObjective: To analyze risk factors and clinical outcomes associated with HAIs in ICU patients.\nMethods: This cross-sectional study was conducted in the ICU of a public hospital with 141 patients (182 HAI cases). Medical records covered ICU admissions from August 1, 2022, to August 31, 2024, and data collection occurred from November 2024 to February 2025. Data were extracted from medical records and the Hospital Infection Control Committee database. Risk factors were assessed at admission using the Rodr\u00edguez-Almeida-Ca\u00f1on (RAC) Scale, which stratifies HAI risk using intrinsic and extrinsic factors and classifies patients as low, moderate, or high risk. Clinical outcomes monitored during hospitalization included hospital discharge, sepsis, septic shock, and death.\nResults: By RAC, 53.9% were moderate risk and 45.4% high risk; lower educational level was associated with higher risk (p = 0.016). Ventilator-associated pneumonia predominated (44.4%). Predominant pathogens were Pseudomonas (28.1%), Acinetobacter (19.1%), and Klebsiella (17.4%), with 34.3% showing carbapenem resistance. Sepsis occurred in 18.5% and septic shock in 30.2%; mortality was 62.9%. Compared with the reference group, odds of discharge were higher among patients aged 20\u201339 years (OR = 12.48; 95% CI: 4.89\u2013102.90; p = 0.002) and 40\u201359 years (OR = 4.33; 95% CI: 3.89\u201335.78; p = 0.019).\nConclusion: RAC screening revealed a high burden of predisposing factors at ICU admission, particularly among patients with lower educational levels, which was associated with worse outcomes. RAC-guided admission screening can support risk-proportional nursing surveillance and targeted prevention bundles, while institutional policies should reinforce microbiological surveillance and antimicrobial stewardship tailored to social vulnerability.<\/jats:p>","DOI":"10.33546\/bnj.4399","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T03:20:27Z","timestamp":1777346427000},"page":"148-157","update-policy":"https:\/\/doi.org\/10.33546\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors and outcomes of healthcare-associated infections in a Brazilian intensive care unit: A cross-sectional study"],"prefix":"10.33546","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-8128","authenticated-orcid":false,"given":"Andressa Maria de","family":"Sousa Moura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2710-2122","authenticated-orcid":false,"given":"\u00c1lvaro Francisco Lopes de","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5913-8886","authenticated-orcid":false,"given":"Herica Emilia F\u00e9lix de","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2877-2806","authenticated-orcid":false,"given":"Maria Z\u00e9lia de Ara\u00fajo","family":"Madeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5632-0332","authenticated-orcid":false,"given":"Daniela Reis Joaquim de","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-3350","authenticated-orcid":false,"given":"Ana Carolina de Macedo","family":"Lima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3195-8767","authenticated-orcid":false,"given":"Liliane Moretti","family":"Carneiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-1865","authenticated-orcid":false,"given":"Marilia Duarte","family":"Valim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5946-0197","authenticated-orcid":false,"given":"Aires Garcia dos Santos","family":"Junior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4975-2727","authenticated-orcid":false,"given":"Odin\u00e9a Maria Amorim","family":"Batista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"19163","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"145763","doi-asserted-by":"crossref","unstructured":"Akubire, B., Gmayinaam, V. U., Anaba, E. A., Appiah, P. K., & Asalu, G. A. (2025). Determinants of health literacy among older adults in Saboba district in Ghana: A cross-sectional study. BMC Public Health, 25(1), 2212. https:\/\/doi.org\/10.1186\/s12889-025-23500-x","DOI":"10.1186\/s12889-025-23500-x"},{"key":"145764","doi-asserted-by":"crossref","unstructured":"Angeloni, N. L. N., Furlan, M. C. R., da Silva Barcelos, L., Ferreira, A. M., de Sousa, A. F. L., Valim, M. D., de Andrade, D., de Oliveira, L. B., Batista, O. M. A., & dos Santos Junior, A. G. (2024). Multimodal educational intervention for adherence to standard precautions in the COVID-19 pandemic among nursing professionals: A quasi-experimental study. 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The Brazilian Journal of Infectious Diseases, 27(6), 103687. https:\/\/doi.org\/10.1016\/j.bjid.2023.103687","DOI":"10.1016\/j.bjid.2023.103687"},{"key":"145767","doi-asserted-by":"crossref","unstructured":"da Silva Pereira, P. P., Sabini, A. A. C., de Deus, J. C., de Ara\u00fajo, L. X., Pontes, D. O., Hang, A. T., de Souza, C. J. M., & Freitas, J. L. G. (2023). Risk factors for healthcare-associated infections in Intensive Care Units. Revista Enfermagem UFPI, 12(1), e3806. https:\/\/doi.org\/10.26694\/reufpi.v12i1.3806","DOI":"10.26694\/reufpi.v12i1.3806"},{"key":"145768","doi-asserted-by":"crossref","unstructured":"de Maio Nascimento, M., Silva, C. N., Alves, D. E., & dos Santos, E. S. (2021). Public policies for the elderly: Investments by Brazilian municipalities between 2005-2014. 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Motivation, job satisfaction, performance, and commitment of surface cleaning staff in a pediatric ICU: A cross-sectional study. KONTAKT-Journal of Nursing & Social Sciences related to Health & Illness, 74(4), 340. https:\/\/doi.org\/10.32725\/kont.2025.051","DOI":"10.32725\/kont.2025.051"},{"key":"145783","doi-asserted-by":"crossref","unstructured":"Puro, V., Coppola, N., Frasca, A., Gentile, I., Luzzaro, F., Peghetti, A., & Sganga, G. (2022). Pillars for prevention and control of healthcare-associated infections: An Italian expert opinion statement. Antimicrobial Resistance & Infection Control, 11(1), 87. https:\/\/doi.org\/10.1186\/s13756-022-01125-8","DOI":"10.1186\/s13756-022-01125-8"},{"key":"145784","doi-asserted-by":"crossref","unstructured":"Ribeiro, E. A., Mundoca, M. P., Cachoeira, M. T., Nobre, L. L., & da Rocha, M. J. (2023). 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