Characterizing the relationship between coronavirus disease 2019 (COVID-19) and central-line-associated bloodstream infection (CLABSI) and assessing the impact of a nursing-focused CLABSI reduction intervention during the COVID-19 pandemic.

Autor:	Ben-Aderet MA; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Madhusudhan MS; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Haroun P; University of California Los Angeles, Los Angeles, California., Almario MJP; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Raypon R; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Fawcett S; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Johnson J; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Girard A; Department of Nursing, Cedars-Sinai Medical Center, Los Angeles, California., Griner T; Department of Nursing, Cedars-Sinai Medical Center, Los Angeles, California., Sheffield L; Department of Nursing, Cedars-Sinai Medical Center, Los Angeles, California., Grein JD; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2023 Jul; Vol. 44 (7), pp. 1108-1115. Date of Electronic Publication: 2022 Aug 31.
DOI:	10.1017/ice.2022.203
Abstrakt:	Objective: To examine the impact of SARS-CoV-2 infection on CLABSI rate and characterize the patients who developed a CLABSI. We also examined the impact of a CLABSI-reduction quality-improvement project in patients with and without COVID-19. Design: Retrospective cohort analysis. Setting: Academic 889-bed tertiary-care teaching hospital in urban Los Angeles. Patients or Participants: Inpatients 18 years and older with CLABSI as defined by the National Healthcare Safety Network (NHSN). Intervention(s): CLABSI rate and patient characteristics were analyzed for 2 cohorts during the pandemic era (March 2020-August 2021): COVID-19 CLABSI patients and non-COVID-19 CLABSI patients, based on diagnosis of COVID-19 during admission. Secondary analyses were non-COVID-19 CLABSI rate versus a historical control period (2019), ICU CLABSI rate in COVID-19 versus non-COVID-19 patients, and CLABSI rates before and after a quality- improvement initiative. Results: The rate of COVID-19 CLABSI was significantly higher than non-COVID-19 CLABSI. We did not detect a difference between the non-COVID-19 CLABSI rate and the historical control. COVID-19 CLABSIs occurred predominantly in the ICU, and the ICU COVID-19 CLABSI rate was significantly higher than the ICU non-COVID-19 CLABSI rate. A hospital-wide quality-improvement initiative reduced the rate of non-COVID-19 CLABSI but not COVID-19 CLABSI. Conclusions: Patients hospitalized for COVID-19 have a significantly higher CLABSI rate, particularly in the ICU setting. Reasons for this increase are likely multifactorial, including both patient-specific and process-related issues. Focused quality-improvement efforts were effective in reducing CLABSI rates in non-COVID-19 patients but were less effective in COVID-19 patients.
Databáze:	MEDLINE
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