Infectious Disease

Some health-related infections increased during the pandemic

September 03, 2021

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According to US data reported in Infection Control & Hospital Epidemiology, the incidence of some health care-related infections increased significantly in 2020 due to pandemic-related disorders.

Among the increases, there were nearly 50% spikes in central line-associated bloodstream infections (CLABSIs) and ventilator-associated infections.

Hospital beds

In the United States, there was an increase in centreline-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events, and MRSA in 2020. Source: Adobe Stock.

“The response to the pandemic has put a strain on acute hospitals, which may have changed staffing practices, increased critical care capacities, and changes in the use of personal protective equipment.” Lindsey M. Weiner-More permanent, MPH, an epidemiologist in the CDC’s Health Promotion Division, and colleagues wrote. “In the early stages of the pandemic, little was known about how COVID-19 hospital admissions would affect the incidence of Health Care Associated Infections (HAIs).”

Weiner-Lastinger and colleagues identified HAIs in 2019 and 2020 that were reported to the National Healthcare Safety Network (NHSN) – the largest nationwide infection monitoring system in the healthcare sector – and calculated the standardized infection rates (SIRs) for each infection on a quarterly basis.

Compared to 2019, the study uncovered a sharp increase in four HAIs in 2020 – CLABSIs, Catheter-Associated Urinary Tract Infections (CAUTIs), Ventilator-Associated Events (VAE), and MRSA bacteremia. The biggest increase was in CLABSIs, which were 46% to 47% higher in the third and fourth quarters of 2020 compared to 2019.

According to the study, there has also been a dramatic increase in the frequency and duration of ventilator use, as well as UAE rates, up about 45% in the fourth quarter of 2020 compared to 2019. The Society for Healthcare Epidemiology of America said in a press release that the sharp rise in SIRs suggests that the rise in infections is not simply due to more devices being used.

CAUTIs increased around 19% in the fourth quarter of 2020 compared to 2019, and MRSA rates were 22 to 34% higher in the third and fourth quarters year over year.

The researchers found no increases in surgical site infections – fewer elective surgeries were performed – or in Clostridioides difficile rates, which could be due to an increased focus on hand hygiene, environmental cleaning, patient isolation and use of personal protective equipment, they said.

“COVID-19 has created a perfect storm for antibiotic resistance and supply-associated infections in healthcare.” Arjun Srinivasan, MD, CDC’s assistant director for Health-Associated Infection Prevention Programs said in a press release. “This information underscores the importance of building stronger, deeper, and broader infection control resources across healthcare that will not only improve our ability to protect patients from future pandemics, but will improve patient care every day.”

The increases came after years of advances in healthcare-associated infections, said Ann Marie Pettis, BSN, RN, CIC, FAPIC, President of the Association for Professionals in Infection Control and Epidemiology.

“The unfortunate reality is that in one year we have lost nearly a decade of advances against HAIs such as centreline-associated bloodstream infections, catheter-associated urinary tract infections, MRSA and ventilator-associated events,” Pettis said in a statement. “APIC urges healthcare institutions to evaluate their infection prevention programs by examining the care and services they offer and determining the appropriate levels of staff and resources needed to protect patients and healthcare workers.”

References:

APIC. Statement by APIC President Ann Marie Pettis, BSN, RN, CIC, FAPIC, on HAI increases. https://apic.org/news/statement-from-apic-president-ann-marie-pettis-bsn-rn-cic-fapic-about-hai-increases/. Accessed September 2, 2021.

Press release.

Weiner-Lastinger LM et al. Infect Control Hosp Epidemiol. 2021; doi: 10.1017 / ice.2021.362.

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