Impact of COVID-19 pandemic on the rates of central line–associated bloodstream infection and catheter-associated urinary tract infection in an intensive care setting: National experience

BACKGROUND: COVID-19 is believed to increase the risk of secondary health care–associated infections. The objective was to estimate the impact of COVID-l9 pandemic on the rates of central line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infections (CAUTIs) in the Ministry of Health hospitals across Saudi Arabia. METHODS: A retrospective analysis of prospectively collected CLABSI and CAUTI data over a period of 3 years (2019-2021) was done. The data were obtained from the Saudi Health Electronic Surveillance Network. All adult intensive care units in 78 Ministry of Health hospitals that contributed CLABSI or CAUTI data before (2019) and during (2020-2021) the pandemic were included. RESULTS: During the study, 1440 CLABSI events and 1119 CAUTI events were identified. CLABSI rates significantly increased in 2020-2021 compared with 2019 (2.50 versus 2.16 per 1000 central line days, P = .010). CAUTI rates significantly decreased in 2020-2021 compared with 2019 (0.96 versus 1.54 per 1000 urinary catheter days, P < .001). CONCLUSIONS: COVID-19 pandemic is associated with increased CLABSI rates and reduced CAUTI rates. It is believed to have negative impacts on several infection control practices and surveillance accuracy. The opposite impacts of COVID-19 on CLABSI and CAUTI probably reflect the nature of their case definitions.