COVID-19 Caused Significant Increase in Healthcare-Associated Infections in 2020

CDC analysis of data from the National Healthcare Safety Network compares infection rates before and during pandemic.

After years of steady declines in healthcare-associated infections, significantly higher rates of four out of six routinely monitored infections were observed in U.S. hospitals, according to a Centers for Disease Control and Prevention analysis of National Healthcare Safety Network (NHSN) data published. today (September 2, 2021) in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. Increases were attributed to factors related to the COVID-19 pandemic, including more and sicker patients requiring more frequent and longer use of catheters and ventilators, as well as staffing and delivery issues.

“COVID-19 created a perfect storm for antibiotic resistance and healthcare-associated infections in healthcare facilities. Prior to the pandemic, public health—working with hospitals—has been successfully driving these infections out in U.S. hospitals for several years,” said Arjun Srinivasan, MD, CDC’s Associate Director of Healthcare Associated Infection Prevention Programs. “Strengthening infection prevention and control capabilities This information highlights the importance of building stronger, deeper and broader means of infection control across healthcare, which will not only improve our ability to protect patients in future pandemics, but also improve patient care every day.”

For this analysis, researchers used data collected through NHSN, the nation’s largest healthcare-related infection monitoring system, used by nearly all U.S. hospitals to meet local, state, or federal infection reporting requirements.

In 2020, large increases were found in four serious infection types compared to 2019: central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events and antibiotic-resistant staph infections. The largest increases were bloodstream infections associated with central line catheters inserted into large blood vessels to deliver medication and other fluids over long periods. The number of central line infections in the third and fourth quarters of 2020 was 46% to 47% higher than in 2019.

With a dramatic increase in the frequency and duration of ventilator use, the number of ventilator-associated infections increased by 45% in the fourth quarter of 2020 compared to 2019. The CDC analysis found sharp increases in standardized infection rates, indicating that the increase is not just a reflection of the use of more devices.

“Infection control practices in COVID-19 wards were often adapted to personal protective equipment shortages, responded to fears of healthcare personnel, and did not always lend themselves to better infection prevention,” said Tara N. Palmore, MD, and David K. Henderson, MD. , from the National Institutes of Health, in an editorial accompanying the study. “The success of recent years, with a steady decline in the number of these (healthcare-related) and device-related infections, has further accentuated the upturn seen in 2020.”

The study found that two other types of infections remained stable or decreased during COVID-19. The number of surgical site infections did not increase due to fewer elective surgeries being performed, largely in operating rooms with uninterrupted infection control processes separate from the COVID wards. In addition, no increase was found in Clostridioides Difficile, or C. diff, a serious bacterial infection that occurs after antibiotic use. The study said lower rates of C. diff may be the result of a greater focus on hand hygiene, environmental cleaning, patient isolation and the use of personal protective equipment.

“Basic infection control practices need to be put into practice so that they are less vulnerable when the health care system is under pressure,” the editorial concluded. expanding efforts to support a pandemic response.”

Reference: “The impact of COVID-19 on healthcare associated infections in 2020; A Summary of Data Reported to the National Healthcare Safety Network” by Lindsey M. Weiner-Lastinger, Vaishnavi Pattabiraman, Rebecca Konnor, Prachi R. Patel, Emily Wong, Sunny Y. Xu, Brittany Smith, Jonathan R. Edwards, Margaret A. Dudeck, Aug. 25, 2021, Infection Control & Hospital Epidemiology.
DOI: 10.117/ice.2021.362

Tara N. Palmore, David K. Henderson. “Healthcare-related infections in the time of pandemic COVID-19.” Infection control and hospital epidemiology. Web (August 25, 2021).