To the Editor—I read with great interest your 3 recent papers by Wong et al1 Ponce-Alonso et al2, and Wee et al,3 who report that coronavirus disease 2019 (COVID-19)–era infection control bundles are associated in significant decreases in many nosocomial viral and bacterial infection rates such as influenza, respiratory syncytial virus, adenovirus, and Clostridium difficile. The Ponce-Alonso Spanish study reported a decrease of 69% in hospital-acquired Clostridium difficile infection rates following implementation of a hospital infection control bundle: incidence density was 8.54 per 10,000 patients day before and 2.68 per 100,000 days after the COVID-19 infection control bundle (P = .0002572).
Other studies have also reported that COVID-19–era infection controls such as hand washing, masking and gowning, better hospital cleaning, and isolation of COVID-19 patients can significantly reduce rates of many bacterial and viral infections. A study in a 1,785-bed Singapore hospital reported that the use of COVID-19–related infection control bundles was associated with significantly reduced rates of many hospital-acquired infections, including nosocomial respiratory infections (incidence rate, 0.08; 95% CI, 0.05–0.13), nosocomial MRSA (IR, 0.54; 95% CI, 0.46–0.64), and central-line bloodstream infections (IR, 0.24; 95% CI, 0.07–0.57).4 A California study involving 37,033 hospital patient days reported that following implementation of a COVID-19 infection control bundle, rates of many multidrug-resistant pathogens decreased significantly including a 41% decrease in methicillin-resistant Staphylococcus aureus (MRSA), a 21% decrease in (extended-spectrum β-lactamase bacteria (ESBL), and an 80% decrease in vancomycin-resistant enterococci (VRE).5
Better hospital infection control bundles can also reduce rates of common nosocomial fungal infections,6 although I am not aware of any current studies that have reported on lower rates of Aspergillus or Candida in the COVID-19 era. Such studies of COVID-19–era nosocomial Aspergillus and Candida rates might yield useful data on how to prevent common life-threatening fungal infections.
Clearly, enhanced infection control procedures need to be followed long after the COVID-19 tragedy has resolved.7 I hope that Infection Control and Hospital Epidemiology will continue to publish more good papers on COVID-19–era infection control.
Acknowledgments
Financial support
No financial support was provided relevant to this article.
Conflicts of interest
The author reports no conflicts of interest relevant to this article.
References
- 1. Wong SC, Lam GK, AuYeung CH, et al. Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: Implication of universal masking in hospitals. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.425. [DOI] [PMC free article] [PubMed]
- 2. Ponce-Alonso M, Sáez de la Fuente J, Rincón-Carlavilla A, et al. Impact of the coronavirus disease 2019 (COVID-19) pandemic on nosocomial Clostridioides difficile infection. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.454. [DOI] [PMC free article] [PubMed]
- 3. Wee LE, Conceicao EP, Sim JXY, Aung MK, Venkatachalam I. Impact of infection prevention precautions on adenoviral infections during the COVID-19 pandemic: experience of a tertiary hospital in Singapore. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.1365. [DOI] [PMC free article] [PubMed]
- 4. Wee LEI, Conceicao EP, Tan JY, et al. Unintended consequences of infection prevention and control measures during COVID-19 pandemic. Am J Infect Control 2020. doi: 10.1016/j.ajic.2020.10.019. [DOI] [PMC free article] [PubMed]
- 5. Cole J, Barnard E. The impact of the COVID-19 pandemic on healthcare acquired infections with multidrug-resistant organisms. Am J Infect Control 2020:5726. doi: 10.1016/j.ajic.2020.09.013. [DOI] [PMC free article] [PubMed]
- 6. Suleyman G, Alangaden GJ. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infect Dis Clin NA 2016;30:1023–1052. [DOI] [PubMed] [Google Scholar]
- 7. Cerulli Irelli E, Morano A, Di Bonaventura C. Reduction in nosocomial infections during the COVID-19 era: a lesson to be learned. Updates Surg 2020. doi: 10.1007/s13304-020-00925-0. [DOI] [PMC free article] [PubMed]