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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2021 Aug 9:ciab688. doi: 10.1093/cid/ciab688

The Impact of COVID-19 on Healthcare-Associated Infections

Meghan A Baker 1,2,#,, Kenneth E Sands 1,3,#, Susan S Huang 4, Ken Kleinman 5, Edward J Septimus 1,6, Neha Varma 1, Jackie Blanchard 3, Russell E Poland 1,3, Micaela H Coady 1, Deborah S Yokoe 7, Sarah Fraker 3, Allison Froman 1, Julia Moody 3, Laurel Goldin 3, Amanda Isaacs 1, Kacie Kleja 3, Kimberly M Korwek 3, John Stelling 2, Adam Clark 2, Richard Platt 1, Jonathan B Perlin 3; For the CDC Prevention Epicenters Program1
PMCID: PMC8385925  PMID: 34370014

Abstract

Background

The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). We aimed to evaluate the association between COVID-19 surges and HAI and cluster rates.

Methods

In 148 HCA Healthcare-affiliated hospitals, 3/1/2020-9/30/2020, and a subset of hospitals with microbiology and cluster data through 12/31/2020, we evaluated the association between COVID-19 surges and HAIs, hospital-onset pathogens, and cluster rates using negative binomial mixed models. To account for local variation in COVID-19 pandemic surge timing, we included the number of discharges with a laboratory-confirmed COVID-19 diagnosis per staffed bed per month.

Results

Central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia increased as COVID-19 burden increased. There were 60% (95% CI, 23-108%) more CLABSI, 43% (95% CI, 8-90%) more CAUTI, and 44% (95% CI, 10-88%) more cases of MRSA bacteremia than expected over 7 months based on predicted HAIs had there not been COVID-19 cases. Clostridioides difficile infection was not significantly associated with COVID-19 burden. Microbiology data from 81 of the hospitals corroborated the findings. Notably, rates of hospital-onset bloodstream infections and multidrug resistant organisms, including MRSA, vancomycin-resistant enterococcus and Gram-negative organisms were each significantly associated with COVID-19 surges. Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased.

Conclusion

COVID-19 surges adversely impact HAI rates and clusters of infections within hospitals, emphasizing the need for balancing COVID-related demands with routine hospital infection prevention.

Keywords: COVID-19, Healthcare-Associated Infections (HAI), Central Line-Associated Blood Stream Infection (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI)


Articles from Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America are provided here courtesy of Oxford University Press

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