Infectious complications in patients with mental and behavioral disorders

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Infectious diseases are still remaining to be one of the leading causes of hospitalization and mortality among patients with mental disorders. Moreover, hospitalization itself increases the risk of nosocomial infections. Patients with organic lesions of the central nervous system, schizophrenia, and alcohol dependence are particularly vulnerable, but research work in this area is limited.

The aim: to study peculiarities and risk factors for infectious complications (IC) in patients with mental disorders hospitalized in a multidisciplinary hospital.

Material and methods. A retrospective study was performed using “Clinical, laboratory, and pharmacotherapeutic peculiarities of the onset and clinical course of infectious complications in patients with psychosomatic profiles (CLIOPS)” database. The study included 727 patients (385 males and 342 females). Frequency and types of IC, their association with underlying diagnosis, and risk factors were analyzed. All the participants were divided into two groups: 360 (49.5%) without IC and 367 (50.5%) with IC. Nosocomial infections accounted for 61.3% of the infectious complications.

Results. The main infectious complications in the studied patients were pneumonia (59.7%, of which 67.6% were nosocomial), urinary tract infections (13.9%), and intra-abdominal infections (6.5%). In patients with organic mental disorders, including symptomatic ones, the incidence of IC was statistically higher than in other groups: χ²(4) = 51.51 (p <0.001). Risk factors for the development of IC included residence in boarding facilities (odds ratio (OR) 1.58), surgical interventions (OR 4.64), use of antipsychotic drugs (OR 2.6), delirium (OR 2.05), and cardiovascular diseases (OR 1.52).

Conclusion. IC are a key cause of hospitalization and mortality in psychiatric patient population. The highest risk of infectious complications is associated with organic CNS lesions. Delirium and the use of psychotropic medications require special monitoring in this category of patients. The development of specialized infection monitoring programs in psychiatric hospitals is necessary.

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作者简介

Anastasia Anderzhanova

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow

Email: AnderzhanovaAA@zdrav.mos.ru
ORCID iD: 0000-0001-7463-8603
SPIN 代码: 8065-0980

MD, PhD (Medicine), head of the Department of clinical pharmacology

俄罗斯联邦, Moscow

Veronika Mazus

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow

Email: MazusVA@zdrav.mos.ru
ORCID iD: 0000-0002-3754-5333

MD, head of the Department of psychiatry for patients with comorbid somatic and mental pathology

俄罗斯联邦, Moscow

Marina Zhuravleva

Scientific Center for Expertise of Medical Products of the Ministry of Healthcare of Russia; I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

Email: ZhuravlevaMV2@mos.ru
ORCID iD: 0000-0002-9198-8661
SPIN 代码: 6267-9901

MD, Dr. Sci. (Medicine), professor, chief external expert – clinical pharmacologist at the Department of Healthcare, deputy director of the Center of Clinical Pharmacology, professor of the Department of clinical pharmacology and propaedeutics of internal medicine

俄罗斯联邦, Moscow; Moscow

Yulia Meleshkina

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow

Email: MeleshkinaYA@zdrav.mos.ru
ORCID iD: 0000-0003-3768-6731
SPIN 代码: 5088-6327

MD, clinical pharmacologist at the Department of clinical pharmacology

俄罗斯联邦, Moscow

Mikhail Tsarev

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow

Email: TsarevMI@zdrav.mos.ru
ORCID iD: 0009-0001-7407-7882
SPIN 代码: 4903-5285

MD, Dr. Sci. (Medicine), deputy chief physician for medical affairs

俄罗斯联邦, Moscow

Maria Lukina

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow

编辑信件的主要联系方式.
Email: mari-luk2010@yandex.ru
ORCID iD: 0000-0003-0032-2651
SPIN 代码: 4570-6074

MD, PhD (Medicine), clinical pharmacologist at the Department of clinical pharmacology

俄罗斯联邦, Moscow

Maria Balalaeva

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow; Academician B.V. Petrovsky Russian Scientific Center of Surgery

Email: BalalaevaMA@zdrav.mos.ru
ORCID iD: 0000-0001-5968-3297
SPIN 代码: 9267-5440

MD, PhD (Medicine), senior researcher at Centralized Department of clinical pharmacology, clinical pharmacologist at the Department of clinical pharmacology

俄罗斯联邦, Moscow; Moscow

Konstantin Loban

N.I. Pirogov City Clinical Hospital No. 1 of the Department of Healthcare of Moscow; N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia (Pirogov University)

Email: doctor.loban@gmail.com

MD, PhD (Medicine), senior researcher at the Department of abdominal surgery of the Institute of surgery), surgeon at the Department of surgery No. 1

俄罗斯联邦, Moscow; Moscow

参考

  1. Sweiss K, Naser AY, Samannodi M, Alwafi H. Hospital admissions due to infectious and parasitic diseases in England and Wales between 1999 and 2019: An ecological study. BMC Infect Dis. 2022;22(1):398. PMID: 35461245. PMCID: PMC9034500. https://doi.org/10.1186/s12879-022-07388-1
  2. Veronese N, Polidori MC, Maggi S, Zamora J, Ruiz-Calvo G, Bangert M et al. Measuring the impact of hospitalization for infectious diseases on the quality of life of older patients in four European countries: The AEQUI longitudinal matched cohort study (2020-2023). Clin Microbiol Infect. 2025;31(5):847–54. PMID: 39842547. https://doi.org/10.1016/j.cmi.2025.01.009
  3. World Health Organization. WHO launches first ever global report on infection prevention and control. 2022 May 6. URL: https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control (date of access – 26.08.2025).
  4. Al Hariri YK, Sulaiman SA, Khan AH, Adnan AS, Al-Ebrahem SQ. Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in peninsular Malaysia: A cross sectional retrospective analysis. Front Med (Lausanne). 2022;9:887292. PMID: 36160172. PMCID: PMC9500579. https://doi.org/10.3389/fmed.2022.887292
  5. Okobi OE, Ayo-Farai O, Tran M, Ibeneme C, Ihezie CO, Ezie OB et al. The impact of infectious diseases on psychiatric disorders: A systematic review. Cureus. 2024;16(8):e66323. PMID: 39238736. PMCID: PMC11377121. https://doi.org/10.7759/cureus.66323
  6. Dadi NCT, Radochova B, Vargova J, Bujdakova H. Impact of healthcare-associated infections connected to medical devices-an update. Microorganisms. 2021;9(11):2332. PMID: 34835457. PMCID: PMC8618630. https://doi.org/10.3390/microorganisms9112332
  7. Fukuta Y, Muder RR. Infections in psychiatric facilities, with an emphasis on outbreaks. Infect Control Hosp Epidemiol. 2013;34(1):80–88. PMID: 23221197. https://doi.org/10.1086/668774
  8. Samokhvalov AV, Irving HM, Rehm J. Alcohol consumption as a risk factor for pneumonia: A systematic review and meta-analysis. Epidemiol Infect. 2010;138(12):1789–95. PMID: 20380771. https://doi.org/10.1017/S0950268810000774
  9. Wang Y, Li S, Zhou Q, Wang Y, Shi J. Vascular dementia has the highest hospitalisation rate in China: A nationwide hospital information system study. Stroke Vasc Neurol. 2023;8(1):59–68. PMID: 36219569. PMCID: PMC9985804. https://doi.org/10.1136/svn-2022-001637
  10. Skelly MK, Wattengel BA, Napierala R Jr, Risbood V, Schroeck J, Sellick JA et al. Impact of mental illness on outcomes of outpatients with community-acquired pneumonia. Int Clin Psychopharmacol. 2019;34(1):45–50. PMID: 30422835. https://doi.org/10.1097/YIC.0000000000000245
  11. Андержанова А.А., Мазус В.А., Мелешкина Ю.А., Лукина М.В., Балалаева М.А. БД КЛИОПС (Клинико-лабораторные и фармакотерапевтические особенности дебюта и течения инфекционных осложнений у пациентов психосоматического профиля) [электронная база данных]. Патент РФ на базу данных № 2025622888. 07.07.2025. Доступ: https://www.fips.ru/registers-web/action?acName=clickRegister®Name=DB (дата обращения – 26.08.2025). [Anderzhanova AA, Mazus VA, Meleshkina YuA, Lukina MV, Balalaeva MA. BD KLOPS (Clinical and Laboratory Pharmacotherapeutic Features of Onset and Course of Infectious Complications in Psychosomatic Patients Database) [database on the Internet]. Russian Federation patent RU 2025622888. 07.07.2025. URL: https://www.fips.ru/registers-web/action?acName=clickRegister®Name=DB (date of access – 26.08.2025) (In Russ.)].
  12. Haga T, Ito K, Sakashita K, Iguchi M, Ono M, Tatsumi K. Risk factors for pneumonia in patients with schizophrenia. Neuropsychopharmacol Rep. 2018;38(4):204–9. PMID: 30353691. PMCID: PMC7292272. https://doi.org/10.1002/npr2.12034
  13. [Okada T, Shioda K, Kobayashi T, Nishida M, Suda S, Kato S. Hospital acquired pneumonia in general hospital psychiatric ward a retrospective study. Seishin Shinkeigaku Zasshi. 2016;118(8):570–83 (In Japanese)]. PMID: 30620475.
  14. Kuo KM, Talley PC, Huang CH, Cheng LC. Predicting hospital-acquired pneumonia among schizophrenic patients: A machine learning approach. BMC Med Inform Decis Mak. 2019;19(1):42. PMID: 30866913. PMCID: PMC6417112. https://doi.org/10.1186/s12911-019-0792-1
  15. Han J, Shen M, Wan Q, Lv Z, Xiao L, Wang G. Risk factors for community-acquired pneumonia among inpatients with mental disorders in a tertiary general hospital. Front Psychiatry. 2022;13:941198. PMID: 35935435. PMCID: PMC9354262. https://doi.org/10.3389/fpsyt.2022.941198
  16. Han J, Lv Z, Shen M, Wan Q, Xiao L, Wang G. Risk factors for hospital-acquired pneumonia among inpatients with mental disorders in a large mental health center within a tertiary general hospital. Am J Infect Control. 2023;51(4):446–53. PMID: 35728721. https://doi.org/10.1016/j.ajic.2022.06.014
  17. Prina E, Ranzani OT, Polverino E, Cilloniz C, Ferrer M, Fernandez L et al. Risk factors associated with potentially antibiotic-resistant pathogens in community-acquired pneumonia. Ann Am Thorac Soc. 2015;12(2):153–60. PMID: 25521229. https://doi.org/10.1513/AnnalsATS.201407-305OC
  18. Gupta NM, Lindenauer PK, Yu PC, Imrey PB, Haessler S, Deshpande A et al. Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia. JAMA Netw Open. 2019;2(6):e195172. PMID: 31173120. PMCID: PMC6563577. https://doi.org/10.1001/jamanetworkopen.2019.5172
  19. Carlson RW, Girgla N, Davis J, Moradi A, Cooper T. Pneumonia is a common and early complication of the Severe Alcohol Withdrawal Syndrome (SAWS). Heart Lung. 2022;55:42–48. PMID: 35468360. https://doi.org/10.1016/j.hrtlng.2022.04.001
  20. Liao J, Shen X, Du Z, Wang X, Miao L. Nutritional status and inflammation as mediators of physical performance and delirium in elderly community-acquired pneumonia patients: A retrospective cohort study. Clin Interv Aging. 2024;19:1641–52. PMID: 39376978. PMCID: PMC11457780. https://doi.org/10.2147/CIA.S483481
  21. Pieralli F, Vannucchi V, Mancini A, Grazzini M, Paolacci G, Morettini A et al. Delirium is a predictor of in-hospital mortality in elderly patients with community acquired pneumonia. Intern Emerg Med. 2014;9(2):195–200. PMID: 24048917. https://doi.org/10.1007/s11739-013-0991-1
  22. Liao J, Xie C, Shen X, Miao L. Predicting delirium in older adults with community-acquired pneumonia: A retrospective analysis of stress hyperglycemia ratio and its interactions with nutrition and inflammation. Arch Gerontol Geriatr. 2025;129:105658. PMID: 39427527. https://doi.org/10.1016/j.archger.2024.105658
  23. Tomasi CD, Vuolo F, Generoso J, Soares M, Barichello T, Quevedo J et al. Biomarkers of delirium in a low-risk community-acquired pneumonia-induced sepsis. Mol Neurobiol. 2017;54(1):722–26. PMID: 26768428. https://doi.org/10.1007/s12035-016-9708-6

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