Impact of the coronavirus disease 2019 pandemic on healthcare-associated infections at intensive care units in South Korea: Data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS)

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. The impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in intensive care units (ICUs) was evaluated. METHODS: A retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System was conducted. Comparisons between incidence rates and microorganism distributions of bloodstream infections (BSIs), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated pneumonia (VAP) before and during the COVID-19 pandemic were performed according to hospital size. RESULTS: The incidence rate of BSI significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period (1.38 vs. 1.23 per 10,000 patient-days, relative change -11.5%; P<0.001). The incidence rate of VAP (1.03 vs. 0.81 per 1,000 device-days, relative change -21.4%; P<0.001) significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period, whereas that rates of CLABSIs (2.30 vs. 2.23 per 1,000 device-days; P=0.19) and CAUTIs (1.26 vs. 1.26 per 1,000 device-days; P=0.99) were similar between the two periods. The rates of BSIs and CLABSIs significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates significantly decreased in small to medium-sized hospitals. The rates of CAUTI and VAP significantly decreased in small-sized hospitals. There were no significant changing trends in the rates of multidrug-resistant pathogens isolated from patients with HAIs between the two periods. CONCLUSION: The incidence rates of BSI and VAP in ICUs decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. This decrease was mainly seen in small to medium-sized hospitals.