No CrossRef data available.
Article contents
Association of the coronavirus disease 2019 (COVID-19) pandemic with the incidence of healthcare-associated infections in California hospitals
Published online by Cambridge University Press: 16 November 2022
Abstract
Objective:
To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of central-line–associated bloodstream infections (CLABSIs), Clostridioides difficile infections (CDIs), and methicillin-resistant Staphyloccocus aureus (MRSA) bloodstream infections (BSIs) in California acute-care hospitals.
Design:
Retrospective cohort and before-and-after study.
Methods:
We compared standardized infection ratios (SIRs) for CLABSI, CDI, and MRSA BSI from the second half of 2020 to the second half of 2019. We performed interrupted time-series (ITS) analyses for these infections to assess departures from long-term trends. We also examined the association between the proportion of facility beds that were occupied by COVID-19 patients in May and June of 2020 and the incidence of infections using negative binomial models. In addition, we compared standardized antimicrobial administration ratios (SAARs) for the second halves of 2019 and 2020.
Results:
We detected substantial and significant increases in the SIRs for CLABSI and MRSA BSI from 2019 to 2020. For the ITS analysis, CLABSI and had significant positive values for the pandemic onset level-change parameters, and CLABSI and MRSA BSI had significant positive values for the postinterruption slope-change parameters. We also detected a positive association between facility COVID-19 patient occupancy and CLABSI and MRSA BSI incidence. We did not detect associations with the onset of the pandemic or COVID-19 patient occupancy and CDI. The SAAR for all antibacterial drugs decreased slightly, but the SAAR for drugs with a high risk for CDI increased slightly.
Conclusions:
This study adds to a body of literature documenting increases in CLABSI and MRSA BSI incidence during the pandemic.
- Type
- Original Article
- Information
- Copyright
- © California Department of Public Health, 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America
References
Weiner-Lastinger, LM, Pattabiraman, V, Konnor, RY, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2022;43:12–25.CrossRefGoogle Scholar
California Department of Public Health. Making Healthcare Safer for All Californians: Healthcare-Associated Infections in California Hospitals Annual Report, January to December 2019, 2020. Sacramento, CA: CDPH; 2020.Google Scholar
California Health and Safety Codes 1288.45–1288.95.Google Scholar
National Healthcare Safety Network. The NHSN standardized infection ratio: a guide to the SIR. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf. Published 2021. Accessed November 1, 2022.Google Scholar
Patient safety analysis resources. Centers for Disease Control and Prevention Website. https://www.cdc.gov/nhsn/ps-analysis-resources/index.html. Accessed October 3, 2022.Google Scholar
All Facilities Letter 20-26. California Department of Public Health website. https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-26.aspx. Published 2020. Accessed November 1, 2022.Google Scholar
Kontopantelis, E, Doran, T, Springate, DA, Buchan, I, Reeves, D. Regression based quasi-experimental approach when randomisation is not an option: interrupted time series analysis. BMJ 2015;350:h2750.CrossRefGoogle Scholar
Richet, H. Seasonality in gram-negative and healthcare-associated infections. Clin Microbiol Infect 2012;18:934–940.CrossRefGoogle ScholarPubMed
Leekha, S, Diekema, DJ, Perencevich, EN. Seasonality of staphylococcal infections. Clin Microbiol Infect 2012;18:927–933.CrossRefGoogle ScholarPubMed
Climate data online search. National Centers for Environmental Data website. https://www.ncdc.noaa.gov/cdo-web/search. Accessed September 14, 2021.Google Scholar
National Healthcare Safety Network. The NHSN standardized antimicrobial administration ratio (SAAR): a guide to the SAAR. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/aur/au-qrg-saartables.pdf. Published 2020. Accessed October 26, 2022.Google Scholar
COVID-19 time-series metrics by county and state. California Health and Human Services Agency website. https://data.chhs.ca.gov/dataset/covid-19-time-series-metrics-by-county-and-state. Published 2022. Accessed August 18, 2022.Google Scholar
McMullen, KM, Smith, BA, Rebmann, T. Impact of SARS-CoV-2 on hospital acquired infection rates in the United States: predictions and early results. Am J Infect Control 2020;48:1409–1411.CrossRefGoogle ScholarPubMed
Stevens, MP, Doll, M, Pryor, R, Godbout, E, Cooper, K, Bearman, G. Impact of COVID-19 on traditional healthcare-associated infection prevention efforts. Infect Control Hosp Epidemiol 2020;41:946–947.CrossRefGoogle ScholarPubMed
Palmore, TN, Henderson, DK. Healthcare-associated infections during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2021;42:1372–1373.CrossRefGoogle ScholarPubMed
Kazakova, SV, Baggs, J, Parra, G, et al. Declines in the utilization of hospital-based care during COVID-19 pandemic. J Hosp Med 2022. doi: 10.1002/jhm.12955.CrossRefGoogle ScholarPubMed
LeBrun, DG, Konnaris, MA, Ghahramani, GC, et al. Increased comorbidity burden among hip fracture patients during the COVID-19 pandemic in New York City. Geriatr Orthop Surg Rehabil 2021;12:21514593211040611.CrossRefGoogle ScholarPubMed
Fakih, MG, Bufalino, A, Sturm, L, et al. Coronavirus disease 2019 (COVID-19) pandemic, central-line–associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): the urgent need to refocus on hardwiring prevention efforts. Infect Control Hosp Epidemiol 2022;43:26–31.CrossRefGoogle ScholarPubMed
Patel, PR, Weiner-Lastinger, LM, Dudeck, MA, et al. Impact of COVID-19 pandemic on central-line–associated bloodstream infections during the early months of 2020, National Healthcare Safety Network. Infect Control Hosp Epidemiol 2022;43:790–793.CrossRefGoogle ScholarPubMed
Baker, M, Sands, K, Huang, S, et al. The impact of COVID-19 on healthcare-associated infections. Clin Infect Dis 2022;74:1748–1754.CrossRefGoogle ScholarPubMed
Parriott et al. supplementary material
Appendix
File
14.6 KB