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171. The Impact of COVID-19 on Healthcare-Associated Infections

BACKGROUND: The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). OBJECTIVE: Evaluate the association between COVID-19 surges and HAI or cluster rates METHODS: Design: Prospecti...

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Autores principales: Baker, Meghan A, Sands, Kenneth, Huang, Susan S, Kleinman, Ken, Septimus, Edward, Varma, Neha, Blanchard, Eunice J, Poland, Russell, Coady, Micaela H, Yokoe, Deborah S, Fraker, Sarah, Froman, Allison, Moody, Julia, Goldin, Laurel, Isaacs, Amanda, Kleja, Kacie, Korwek, Kimberly, Stelling, John, Clark, Adam, Platt, Richard, Perlin, Jonathan B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644472/
http://dx.doi.org/10.1093/ofid/ofab466.171
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author Baker, Meghan A
Sands, Kenneth
Huang, Susan S
Kleinman, Ken
Septimus, Edward
Varma, Neha
Blanchard, Eunice J
Poland, Russell
Coady, Micaela H
Yokoe, Deborah S
Yokoe, Deborah S
Fraker, Sarah
Froman, Allison
Moody, Julia
Goldin, Laurel
Isaacs, Amanda
Kleja, Kacie
Korwek, Kimberly
Stelling, John
Clark, Adam
Platt, Richard
Perlin, Jonathan B
author_facet Baker, Meghan A
Sands, Kenneth
Huang, Susan S
Kleinman, Ken
Septimus, Edward
Varma, Neha
Blanchard, Eunice J
Poland, Russell
Coady, Micaela H
Yokoe, Deborah S
Yokoe, Deborah S
Fraker, Sarah
Froman, Allison
Moody, Julia
Goldin, Laurel
Isaacs, Amanda
Kleja, Kacie
Korwek, Kimberly
Stelling, John
Clark, Adam
Platt, Richard
Perlin, Jonathan B
author_sort Baker, Meghan A
collection PubMed
description BACKGROUND: The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). OBJECTIVE: Evaluate the association between COVID-19 surges and HAI or cluster rates METHODS: Design: Prospective cohort study SETTING: 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 PATIENTS: All inpatients MEASUREMENTS: 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 at each hospital. 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 (P ≤ 0.001 for all), with 60% (95% CI, 23 to 108%) more CLABSI, 43% (95% CI, 8 to 90%) more CAUTI, and 44% (95% CI, 10 to 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 (CDI) 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 (P < 0.05 for all). Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased (P = 0.02). LIMITATIONS: Variations in surveillance and reporting may affect HAI data. Table 1. Effect of an increase in number of COVID-19 discharges on HAIs and hospital-onset pathogens [Image: see text] Figure 1. Predicted mean HAI rates as COVID-19 discharges increase [Image: see text] Predicted mean HAI rate by increasing monthly COVID-19 discharges. Panel a. CLABSI, Panel b, CAUTI Panel c. MRSA Bacteremia, Panel d. CDI. Data are stratified by small, medium and large hospitals. Figure 2. Monthly comparison of COVID discharges to clusters [Image: see text] COVID-19 discharges and the number of clusters of hospital-onset pathogens are correlated throughout the pandemic. 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. DISCLOSURES: Kenneth Sands, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Ken Kleinman, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Edward Septimus, MD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Eunice J. Blanchard, MSN RN, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Russell Poland, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Micaela H. Coady, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Deborah S. Yokoe, MD, MPH, Nothing to disclose Julia Moody, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Richard Platt, MD, MSc, Medline (Research Grant or Support, Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Jonathan B. Perlin, MD, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)
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spelling pubmed-86444722021-12-06 171. The Impact of COVID-19 on Healthcare-Associated Infections Baker, Meghan A Sands, Kenneth Huang, Susan S Kleinman, Ken Septimus, Edward Varma, Neha Blanchard, Eunice J Poland, Russell Coady, Micaela H Yokoe, Deborah S Yokoe, Deborah S Fraker, Sarah Froman, Allison Moody, Julia Goldin, Laurel Isaacs, Amanda Kleja, Kacie Korwek, Kimberly Stelling, John Clark, Adam Platt, Richard Perlin, Jonathan B Open Forum Infect Dis Oral Abstracts BACKGROUND: The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). OBJECTIVE: Evaluate the association between COVID-19 surges and HAI or cluster rates METHODS: Design: Prospective cohort study SETTING: 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 PATIENTS: All inpatients MEASUREMENTS: 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 at each hospital. 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 (P ≤ 0.001 for all), with 60% (95% CI, 23 to 108%) more CLABSI, 43% (95% CI, 8 to 90%) more CAUTI, and 44% (95% CI, 10 to 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 (CDI) 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 (P < 0.05 for all). Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased (P = 0.02). LIMITATIONS: Variations in surveillance and reporting may affect HAI data. Table 1. Effect of an increase in number of COVID-19 discharges on HAIs and hospital-onset pathogens [Image: see text] Figure 1. Predicted mean HAI rates as COVID-19 discharges increase [Image: see text] Predicted mean HAI rate by increasing monthly COVID-19 discharges. Panel a. CLABSI, Panel b, CAUTI Panel c. MRSA Bacteremia, Panel d. CDI. Data are stratified by small, medium and large hospitals. Figure 2. Monthly comparison of COVID discharges to clusters [Image: see text] COVID-19 discharges and the number of clusters of hospital-onset pathogens are correlated throughout the pandemic. 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. DISCLOSURES: Kenneth Sands, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Ken Kleinman, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Edward Septimus, MD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Eunice J. Blanchard, MSN RN, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Russell Poland, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Micaela H. Coady, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Deborah S. Yokoe, MD, MPH, Nothing to disclose Julia Moody, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Richard Platt, MD, MSc, Medline (Research Grant or Support, Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Jonathan B. Perlin, MD, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Oxford University Press 2021-12-04 /pmc/articles/PMC8644472/ http://dx.doi.org/10.1093/ofid/ofab466.171 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Oral Abstracts
Baker, Meghan A
Sands, Kenneth
Huang, Susan S
Kleinman, Ken
Septimus, Edward
Varma, Neha
Blanchard, Eunice J
Poland, Russell
Coady, Micaela H
Yokoe, Deborah S
Yokoe, Deborah S
Fraker, Sarah
Froman, Allison
Moody, Julia
Goldin, Laurel
Isaacs, Amanda
Kleja, Kacie
Korwek, Kimberly
Stelling, John
Clark, Adam
Platt, Richard
Perlin, Jonathan B
171. The Impact of COVID-19 on Healthcare-Associated Infections
title 171. The Impact of COVID-19 on Healthcare-Associated Infections
title_full 171. The Impact of COVID-19 on Healthcare-Associated Infections
title_fullStr 171. The Impact of COVID-19 on Healthcare-Associated Infections
title_full_unstemmed 171. The Impact of COVID-19 on Healthcare-Associated Infections
title_short 171. The Impact of COVID-19 on Healthcare-Associated Infections
title_sort 171. the impact of covid-19 on healthcare-associated infections
topic Oral Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644472/
http://dx.doi.org/10.1093/ofid/ofab466.171
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