# Exploring the Link Between Causative Agents of Healthcare-Associated Infections and Predisposing Factors Causing Extended Hospital Stays

## TL;DR

This study examines how healthcare-associated infections and patient factors affect hospital stays, finding that patient-specific factors may matter more than infection type.

## Contribution

The study provides new insights into how patient-specific factors, rather than infection type or gender, influence hospital stay duration.

## Key findings

- Gender differences were not statistically significant for any of the infections.
- Hospital stay duration was not significantly associated with the type of causative agent.
- Patient-specific factors like comorbidities and treatment strategies may have a greater influence on outcomes.

## Abstract

Background

Healthcare-related infections initially meant those infections that developed during a stay in an extended-care hospital, but currently are used to describe the infections that develop in the continuum of healthcare settings where individuals receive care.

Aim

The aim of this study is to explore the relationship between causative agents of healthcare-associated infections (HAIs) and predisposing factors contributing to extended hospital stays. It seeks to generate insights that improve patient care, optimize outcomes, and reduce infection-related burdens.

Method

This retrospective cohort study was conducted at Dr. Hassan Ghazzawi Hospital, Jeddah, Saudi Arabia, using data from the medical records department. All patients who received an HAI diagnosis while in the hospital between January 2024 and December 2024 made up the research population. In line with this background, this study investigated the distribution of causative agents of infection in hospitalized patients (n = 60) with respect to gender and length of hospital stay. The study design and reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Results

Data were collected on 10 major pathogens, including Klebsiella pneumoniae, Acinetobacter baumannii, and methicillin-resistant Staphylococcus aureus (MRSA), among others. The Kruskal-Wallis test was applied to assess differences in mean hospital stay, while the Chi-square test was utilized to assess the relation between gender and hospital-born causative agents. Result shows that gender differences were not statistically significant for any of the infections (all p > 0.05). An independent t-test of the total pathogen counts in males and females revealed no significant difference (t-test p = 0.594). The F-test, which compares variance, also revealed no discernible variation in group variability (F = 0.964, p = 0.521). Although certain infections, such as Klebsiella pneumoniae and Acinetobacter baumannii, were more frequent, the overall distribution did not differ significantly by gender. The Kruskal-Wallis test was conducted to determine whether hospital stay differed significantly across patients with different causative agents of HCAIs. Statistical analysis did not demonstrate a significant difference in hospital stay between the different causative agents. One-way analysis of variance (ANOVA) yielded F = 1.65 and p = 0.126, and the nonparametric Kruskal-Wallis H test also confirmed nonsignificance (H = 7.96, p = 0.538). This indicates that the type of causative agent was associated with variations in the length of hospital stay, meaning variation in hospital stay appears to be more patient-specific rather than strongly dependent on the causative agent of infection.

Conclusion

These findings suggest that factors other than pathogen type and gender such as severity of illness, underlying comorbidities, host immune status, treatment strategies, timeliness of intervention, antimicrobial resistance (AMR) patterns, hospital hygiene regulation, adequacy of infection control practices, staffing ratios, availability of critical care resources, and overall quality of the hospital care system may have a greater influence on patient outcomes.