<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2022000100013</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.2022.01.292</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Nosocomial Infections. COVID-19: A Friend or Foe?]]></article-title>
<article-title xml:lang="pt"><![CDATA[Infeções Nosocomiais. COVID-19: Amigo ou Inimigo?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Laura Bonito]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins-dos-Santos]]></surname>
<given-names><![CDATA[Gonçalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ilharco]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vieira]]></surname>
<given-names><![CDATA[Marta Mello]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Midões]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[Inês]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soares]]></surname>
<given-names><![CDATA[Leonor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fevereiro]]></surname>
<given-names><![CDATA[Maria do Carmo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de São José Centro Hospitalar Universitário de Lisboa Central Department of Internal Medicine 1.4]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital de Dona Estefânia Centro Hospitalar Universitário de Lisboa Central Department of Immunoallergology]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de Santo António dos Capuchos Centro Hospitalar Universitário de Lisboa Central Department of Hematology]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>29</volume>
<numero>1</numero>
<fpage>13</fpage>
<lpage>19</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2022000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2022000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2022000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Nosocomial Infections constitute a public health problem and bring excess avoidable costs associated with hospital admissions. Over the COVID-19 pandemics there was a shift in policies focusing on infection prevention and control programs.  Methods:  We postulate that such shift may have an indirect effect in the occurrence of nosocomial infections. We performed a retrospective study aiming to compare the differences in nosocomial infection prevalence between a COVID-19 period and a non-COVID-19 period, in a free-COVID-19 Internal Medicine ward from a central hospital in Lisbon. We included 393 patients, 192 patients being from the non-COVID-19 period and 201 patients from the COVID-19 period.  Results:  We found a statistically significant reduction in the occurrence of nosocomial infections in the COVID-19 period from 16.1% (n = 31) to 5.5% (n = 11) (p = 0.001; OR 0.301; 95% CI: 0.146-0.617). We also found a statistically significant reduction in antibiotic usage (n = 31; 16.1% vs n = 11; 5.5%; p = 0.001) and in the occurrence of multidrug resistant organism infection (n = 9; 29.0% vs n = 1; 9.1%; p = 0.009) in the COVID-19 period.  Conclusion:  Our results confirm that after implementation of systematic infection control protocols there was a reduction in nosocomial infections. We suggest further investigation to validate the data obtained and a cost-benefit analysis to clarify whether the universal implementation of infection prevention and control measures will add value to the treatment of patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  As infeções nosocomiais constituem um problema de saúde pública e trazem custos excessivos evitáveis associados aos internamentos hospitalares. Durante a pandemia da COVID-19, houve uma mudança nas políticas com foco em programas de prevenção e controlo de infeção.  Métodos:  Postulamos que tal mudança pode ter um efeito indireto na ocorrência de Infeções nosocomiais. Realizámos um estudo retrospetivo com o objetivo de comparar as diferenças na prevalência de infeção hospitalar entre um período COVID-19 e um período não COVID-19, numa enfermaria de Medicina Interna de um hospital central de Lisboa, sem doen-tes com COVID-19. Foram incluídos 393 pacientes, sendo 192 do período não COVID-19 e 201 do período COVID-19.  Resultados:  Encontramos uma redução estatisticamente significativa na ocorrência de infeções nosocomiais no período COVID-19 de 16,1% (n = 31) para 5,5% (n = 11) (p = 0,001; OR 0,301; IC 95%: 0,146-0,617). Também encontramos uma redução estatisticamente significativa no uso de antibióticos (n = 31; 16,1% vs n = 11; 5,5%; p = 0,001) e na ocorrência de infeção por organismos multirresistentes (n = 9; 29,0% vs n = 1; 9,1%; p = 0,009) no período COVID-19.  Conclusão:  Estes resultados confirmam que, após a implementação de protocolos sistemáticos de controlo de infeção, houve uma redução nas infeções nosocomiais. Sugerimos uma investigação mais aprofundada para validar os dados obtidos e uma análise custo-benefício para esclarecer se a implementação universal das medidas de prevenção e controlo de infeção constituirão uma mais-valia para o tratamento dos doentes.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Controlo de Infeções]]></kwd>
<kwd lng="pt"><![CDATA[COVID-19;Infeção Hospitalar/prevenção e controlo.]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[Cross Infection/prevention &amp; control]]></kwd>
<kwd lng="en"><![CDATA[Infection Control.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Horan]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Andrus]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dudeck]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[CDC/NHSN surveillance definition of health careassociated infection and criteria for specific types of infections in the acute care setting]]></article-title>
<source><![CDATA[Am J Infect Control]]></source>
<year>2008</year>
<volume>36</volume>
<page-range>309-32</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cassini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Plachouras]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Eckmanns]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Abu Sin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Blank]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
<name>
<surname><![CDATA[Ducomble]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Burden of Six Healthcare-Associated Infections on European Po-pulation Health Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study]]></article-title>
<source><![CDATA[PLoS Med]]></source>
<year>2016</year>
<volume>13</volume>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<collab>WHO's</collab>
<source><![CDATA[first global report on antibiotic resistance reveals serious, worldwi-de threat to public health]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tchouaket]]></surname>
<given-names><![CDATA[EN]]></given-names>
</name>
<name>
<surname><![CDATA[Beogo]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Sia]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kilpatrick]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Séguin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Baillot]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protocol for a systematic review of economic analyses of nosocomial infection prevention and control interventions in OECD hospitals]]></article-title>
<source><![CDATA[BMJ Open]]></source>
<year>2020</year>
<volume>10</volume>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A Novel Coro-navirus from Patients with Pneumonia in China, 2019]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2020</year>
<volume>382</volume>
<page-range>727-33</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ge]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Yuan]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Xiao]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Deng]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The epidemiology and clinical information about COVID-19]]></article-title>
<source><![CDATA[Eur J Clin Microbiol Infect Dis]]></source>
<year>2020</year>
<volume>39</volume>
<page-range>1011-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahn]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Myoung]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Corona-virus Disease 2019 (COVID-19)]]></article-title>
<source><![CDATA[J Microbiol Biotechnol]]></source>
<year>2020</year>
<volume>30</volume>
<page-range>31324</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gandhi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Yokoe]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Havlir]]></surname>
<given-names><![CDATA[DV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asymptomatic Transmission, the Achi-lles' Heel of Current Strategies to Control Covid-19]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2020</year>
<volume>382</volume>
<page-range>2158-60</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Doshi]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Mackay]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wallach]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Healthcare-associated Infec-tions epidemiology, prevention, and therapy]]></article-title>
<source><![CDATA[Mt Sinai J Med]]></source>
<year>2009</year>
<volume>76</volume>
<page-range>84-94</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Harbarth]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ruef]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Francioli]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nosocomial infec-tions in Swiss university hospitals a multi-centre survey and review of the published experience. Swiss-Noso Network]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Widmer]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pittet]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<source><![CDATA[Schweiz Med Wochenschr]]></source>
<year>1999</year>
<volume>129</volume>
<page-range>1521-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nicastri]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Petrosillo]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Martini]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Larosa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gesu]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
<name>
<surname><![CDATA[Ippolito]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of nosocomial infections in 15 Italian hospitals first point prevalance study for the INF-NOS project]]></article-title>
<collab>INF-NOS Study Group</collab>
<source><![CDATA[Infection]]></source>
<year>2003</year>
<volume>31</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>10-5</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eriksen]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Iversen]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Aavitsland]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of nosocomial infections in hospitals in Norway, 2002 and 2003]]></article-title>
<source><![CDATA[J Hosp Infect]]></source>
<year>2005</year>
<volume>60</volume>
<page-range>40-5</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shuman]]></surname>
<given-names><![CDATA[EK]]></given-names>
</name>
<name>
<surname><![CDATA[Chenoweth]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Urinary Catheter-Associated Infections]]></article-title>
<source><![CDATA[Infect Dis Clin N Am]]></source>
<year>2018</year>
<volume>32</volume>
<page-range>885-97</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Karam]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Chastre]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wilcox]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Vincent]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotic strategies in the era of multidrug resistance]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2016</year>
<volume>20</volume>
<page-range>136</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vestergaard]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Nielsen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Richter]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Schmid]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bustos]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Braeye]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Excess all-cause mortality during the COVID-19 pandemic in Europe -preliminary pooled estimates from the EuroMOMO network, March to April 2020]]></article-title>
<collab>ECDC Public Health Emergency Team for COVID-19.Krause TG.Mølbak K</collab>
<source><![CDATA[Euro Surveill]]></source>
<year>2020</year>
<volume>25</volume>
<page-range>2001214</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nogueira]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Excess Mortality Estimation During the COVID-19 Pandemic Preliminary Data from Portugal]]></article-title>
<collab>De Araújo Nobre M.Nicola PJ.Furtado C.Vaz Carneiro A</collab>
<source><![CDATA[Acta Med Port]]></source>
<year>2020</year>
<volume>33</volume>
<page-range>376-83</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
