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Healthcare-associated infections (HAIs) during the coronavirus disease 2019 (COVID-19) pandemic: A time-series
John M Sahrmann1, Katelin B Nickel1, Dustin Stwalley1
1Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Insights
The COVID-19 pandemic led to increased healthcare-associated infections (HAIs), including CLABSIs, CAUTIs, and VAEs, across three Missouri hospitals. Maintaining infection prevention practices is crucial to mitigate these risks.
Area of Science:
- Infection Control and Hospital Epidemiology
- Public Health
- Health Services Research
Background:
- The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to healthcare systems globally.
- Understanding the pandemic's impact on healthcare-associated infections (HAIs) is critical for patient safety and resource allocation.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on the rates of healthcare-associated infections (HAIs).
- To test the hypothesis that the pandemic was associated with higher HAI rates after adjusting for confounders.
Main Methods:
- Interrupted time-series analysis was employed to assess changes in HAI rates.
- Data were collected from 3 hospitals in Missouri between January 1, 2017, and August 31, 2020.
- Two counterfactual scenarios were used to model potential outcomes.
Main Results:
- The COVID-19 pandemic was associated with increased rates of central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated events (VAEs).
- Increases varied in statistical significance across the three hospitals and by infection type.
- Hypothetical excess HAI calculations indicated a rise in most infection types, with exceptions noted at one hospital under a 'no pandemic' scenario.
Conclusions:
- The COVID-19 era correlated with a rise in CLABSIs, CAUTIs, and VAEs across the studied hospitals.
- Healthcare facilities must maintain rigorous infection prevention strategies to combat HAIs.
- Ongoing surveillance and adaptation of practices are essential in response to public health crises.
Objective:
To use interrupted time-series analyses to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infections (HAIs). We hypothesized that the pandemic would be associated with higher rates of HAIs after adjustment for confounders.
Design:
We conducted a cross-sectional study of HAIs in 3 hospitals in Missouri from January 1, 2017, through August 31, 2020, using interrupted time-series analysis with 2 counterfactual scenarios.
Setting:
The study was conducted at 1 large quaternary-care referral hospital and 2 community hospitals.
Participants:
All adults ≥18 years of age hospitalized at a study hospital for ≥48 hours were included in the study.
Results:
In total, 254,792 admissions for ≥48 hours occurred during the study period. The average age of these patients was 57.6 (±19.0) years, and 141,107 (55.6%) were female. At hospital 1, 78 CLABSIs, 33 CAUTIs, and 88 VAEs were documented during the pandemic period. Hospital 2 had 13 CLABSIs, 6 CAUTIs, and 17 VAEs. Hospital 3 recorded 11 CLABSIs, 8 CAUTIs, and 11 VAEs. Point estimates for hypothetical excess HAIs suggested an increase in all infection types across facilities, except for CLABSIs and CAUTIs at hospital 1 under the "no pandemic" scenario.
Conclusions:
The COVID-19 era was associated with increases in CLABSIs, CAUTIs, and VAEs at 3 hospitals in Missouri, with variations in significance by hospital and infection type. Continued vigilance in maintaining optimal infection prevention practices to minimize HAIs is warranted.
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