The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections.

Autor:	Baker MA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.; Brigham and Women's Hospital, Boston, Massachusetts, USA., Sands KE; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.; HCA Healthcare, Nashville, Tennessee, USA., Huang SS; University of California Irvine School of Medicine, Orange, California, USA., Kleinman K; University of Massachusetts Amherst, Amherst, Massachusetts, USA., Septimus EJ; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.; Texas A&M College of Medicine, Houston, Texas, USA., Varma N; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA., Blanchard J; HCA Healthcare, Nashville, Tennessee, USA., Poland RE; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.; HCA Healthcare, Nashville, Tennessee, USA., Coady MH; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA., Yokoe DS; University of California San Francisco, San Francisco, California, USA., Fraker S; HCA Healthcare, Nashville, Tennessee, USA., Froman A; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA., Moody J; HCA Healthcare, Nashville, Tennessee, USA., Goldin L; HCA Healthcare, Nashville, Tennessee, USA., Isaacs A; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA., Kleja K; HCA Healthcare, Nashville, Tennessee, USA., Korwek KM; HCA Healthcare, Nashville, Tennessee, USA., Stelling J; Brigham and Women's Hospital, Boston, Massachusetts, USA., Clark A; Brigham and Women's Hospital, Boston, Massachusetts, USA., Platt R; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA., Perlin JB; HCA Healthcare, Nashville, Tennessee, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 May 30; Vol. 74 (10), pp. 1748-1754.
DOI:	10.1093/cid/ciab688
Abstrakt:	Background: The profound changes wrought by coronavirus disease 2019 (COVID-19) on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). We aimed to evaluate the association between COVID-19 surges and HAI and cluster rates. Methods: In 148 HCA Healthcare-affiliated hospitals, from 1 March 2020 to 30 September 2020, and a subset of hospitals with microbiology and cluster data through 31 December 2020, 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. 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. There were 60% (95% confidence interval [CI]: 23-108%) more CLABSI, 43% (95% CI: 8-90%) more CAUTI, and 44% (95% CI: 10-88%) more cases of MRSA bacteremia than expected over 7 months based on predicted HAIs had there not been COVID-19 cases. Clostridioides difficile infection 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. Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased. Conclusions: 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. (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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