‘Perfect storm’: Some health care-associated infections spiked during pandemic
The incidence of some health care-associated infections increased significantly in 2020 due to pandemic-related disruptions, according to U.S. data reported in Infection Control & Hospital Epidemiology.
Among the increases, there were nearly 50% spikes in central line-associated bloodstream infections (CLABSIs) and ventilator-associated infections.
“The pandemic response placed burden on acute-care hospitals, which may have altered staffing practices, increased critical care capacity and modified use of personal protective equipment,” Lindsey M. Weiner-Lastinger, MPH, an epidemiologist in the CDC’s Division of Healthcare Quality Promotion, and colleagues wrote. “In the early stages of the pandemic, little was known about how COVID-19 hospitalizations would affect the incidence of health care-associated infections (HAIs).”
Weiner-Lastinger and colleagues identified HAIs reported to the National Healthcare Safety Network (NHSN) — the nation’s largest health care-associated infection surveillance system —in 2019 and 2020 and calculated the standardized infection ratios (SIRs) for each infection by quarter.
Compared with 2019, the study uncovered major increases in four HAIs in 2020 — CLABSIs, catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs) and MRSA bacteremia. The largest increases occurred in CLABSIs, which were around 46% to 47% higher in the third and fourth quarters of 2020 compared with 2019.
According to the study, there also were dramatic increases in the frequency and duration of ventilator use and rates of VAEs, which rose by around 45% in the fourth quarter of 2020 compared with 2019. The Society for Healthcare Epidemiology of America noted in a press release that the sharp increases in SIRs indicate that the increase in infections was not simply a reflection of more devices being used.
CAUTIs increased by around 19% in the fourth quarter in 2020 compared with 2019, and MRSA rates were 22% to 34% higher in the third and fourth quarters than the previous year.
The researchers found no increases in surgical-site infections — fewer elective surgeries were performed — or Clostridioides difficile rates, which could be a result of increased focus on hand hygiene, environmental cleaning, patient isolation and use of personal protective equipment, they said.
“COVID-19 created a perfect storm for antibiotic resistance and health care-associated infectionsin health care settings,” Arjun Srinivasan, MD, CDC’s Associate Director of Healthcare Associated Infection Prevention Programs, said in a press release. “This information emphasizes the importance of building stronger, deeper and broader infection control resources throughout health care that will not only improve our ability to protect patients in future pandemics but will also improve patient care every day.”
The increases came after years of progress against nosocomial 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 1 year, we lost nearly a decade of progress against HAIs like central line-associated bloodstream infections, catheter-associated urinary tract infections, MRSA, and ventilator-associated events,” Pettis said in a statement. “APIC is calling on health care facilities to assess their infection prevention programs by looking at the care and services they provide and determining the appropriate level of personnel and resources necessary to protect patients and health care workers.”
References:
APIC. Statement from APIC President, Ann Marie Pettis, BSN, RN, CIC, FAPIC, about HAI increases. https://apic.org/news/statement-from-apic-president-ann-marie-pettis-bsn-rn-cic-fapic-about-hai-increases/. Accessed on 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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