How COVID-19 Impacted CAUTI and CLABSI Rates in Alabama

BACKGROUND: The study objective was to quantify infection rate trends for central-line associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) in 89 Alabama hospitals from 2015-2021 to analyze how the COVID-19 pandemic impacted healthcare delivery. METHODS: Retrospective analysis of CLABSI and CAUTI rates, from 89 Alabama hospitals via data from the Alabama Department of Public Health from 2015-2021. RESULTS: Based on our modeling strategies, there was a statistically significant decrease in rates of CAUTIs from 2015 to 2019 at an estimated rate of 7% per year (p = 0.0167) and CLABSIs from 2015-2018 at an estimated rate of 13% per year (p < 0.001) in these hospitals. In 2020, the CAUTI and CLABSI rate began increasing at a modeled rate of 29% per year (p = 0.001) and 35% per year (p < 0.001) respectively. DISCUSSION: A review of potential causes for the elevated rate of HAIs illustrated that certain practices may have contributed to increased CAUTI and CLABSI rates. Utilizing staff from non-critical care areas with less experience in HAI prevention, batching of tasks to conserve PPE, and a nationwide mental health crisis could have affected infection prevention bundle compliance. CONCLUSIONS: An increase in CAUTIs and CLABSIs was observed during the pandemic, likely due to large volume of patients requiring advanced medical care and subsequent depleted resources.