171. The Impact of COVID-19 on Healthcare-Associated Infections

Abstract Background The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance on hospital measures, including healthcare-associated infections (HAIs). Objective Evaluate the association between COVID-19 surges and HAI or cluster rates Methods Design: Prospective cohort study Setting 148 HCA Healthcare-affiliated hospitals, 3/1/2020-9/30/2020, and a subset of hospitals with microbiology and cluster data through 12/31/2020 Patients All inpatients Measurements 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 at each hospital. 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 (P ≤ 0.001 for all), with 60% (95% CI, 23 to 108%) more CLABSI, 43% (95% CI, 8 to 90%) more CAUTI, and 44% (95% CI, 10 to 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 (CDI) 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 (P < 0.05 for all). Finally, clusters of hospital-onset pathogens increased as the COVID-19 burden increased (P = 0.02). Limitations Variations in surveillance and reporting may affect HAI data. Table 1. Effect of an increase in number of COVID-19 discharges on HAIs and hospital-onset pathogens Figure 1. Predicted mean HAI rates as COVID-19 discharges increase Predicted mean HAI rate by increasing monthly COVID-19 discharges. Panel a. CLABSI, Panel b, CAUTI Panel c. MRSA Bacteremia, Panel d. CDI. Data are stratified by small, medium and large hospitals. Figure 2. Monthly comparison of COVID discharges to clusters COVID-19 discharges and the number of clusters of hospital-onset pathogens are correlated throughout the pandemic. Conclusion 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. Disclosures Kenneth Sands, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Ken Kleinman, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Edward Septimus, MD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic products) Eunice J. Blanchard, MSN RN, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Russell Poland, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Micaela H. Coady, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Deborah S. Yokoe, MD, MPH, Nothing to disclose Julia Moody, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Richard Platt, MD, MSc, Medline (Research Grant or Support, Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product) Jonathan B. Perlin, MD, PhD, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)

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593. Burden of Healthcare-Associated Infections among Hospitalized Infants within Community Hospitals

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.662 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S279-S280

Author(s):

Ibukunoluwa C Akinboyo ◽

Rebecca R Young ◽

Michael J Smith ◽

Becky A Smith ◽

Sarah S Lewis ◽

...

Keyword(s):

Infection Control ◽

Neonatal Intensive Care ◽

Bloodstream Infections ◽

Central Line ◽

Control Network ◽

Healthcare Associated Infections ◽

Community Hospitals ◽

Tract Infections ◽

Healthcare Associated ◽

The Impact

Abstract Background Healthcare-associated infections (HAI) remain the leading cause of morbidity and mortality among hospitalized children. Within community hospitals with targeted infection prevention efforts, participation in an infection control network has led to significant decreases in device or procedure-related infections among adult patients. The impact of these interventions has not been assessed in pediatric patients admitted to community hospitals. Methods We conducted a retrospective cohort study to describe the burden of HAI among hospitalized infants (< 1 year old) within 53 community hospitals participating in the Duke Infection Control Outreach Network (DICON) from 2013–2018. We determined the frequency of device-related HAI, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and hospital-associated pneumonia or ventilator-associated events (HAP/VAE) using National Healthcare Safety Network (NHSN) definitions; and the burden of HAIs among neonatal intensive care units (NICU) and non-NICU centers. The trend of HAI was analyzed with Spearman’s correlation. Results Thirty hospitals reported 150 HAI among 141 infants over the 6-year period. Median (IQR) time to infection was 10 (4, 20) days after admission. Hospitals with a NICU (15) reported more HAI (median 5, (IQR: 3, 12)) than hospitals without a NICU (median 2 (IQR: 1, 2)) (P = 0.031). CLABSI represented 35% of HAI, HAP/VAE were 23% and CAUTI were 12%. The most frequently isolated primary organism for all HAI was Escherichia coli (22 HAI, 15%) which was also isolated in 39% of CAUTI. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (S. aureus) were the most commonly isolated organisms among CLABSI (17%) and HAP/VAE (33%). Nine centers with ≥4 years of NICU and Central line (CL) use data reported a median (IQR) rate of 1.2 (0, 2.4) CLABSIs/1,000 central line days. There was no change in median CLABSI rate over time (P = 0.47), Figure 1. Conclusion CLABSI, most commonly caused by S. aureus, represented the majority of HAI reported from hospitalized infants within community hospitals participating in an infection control network. Further research into device utilization practices may inform future interventions to reduce HAI. Disclosures All authors: No reported disclosures.

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Healthcare-associated Infections in Pediatric Cardiovascular Surgery Intensive Care Unit between 2016-2020

Kosuyolu Heart Journal ◽

10.51645/khj.2021.m125 ◽

2021 ◽

Author(s):

Mehmet Emirhan Işık ◽

Ergin Arslanoğlu ◽

Ömer Faruk Şavluk ◽

Hakan Ceyran

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Cardiovascular Surgery ◽

Heart Diseases ◽

Bloodstream Infections ◽

Healthcare Associated Infections ◽

Developmental Problems ◽

Pediatric Cardiovascular Surgery ◽

Tract Infections ◽

Healthcare Associated

Objectives: Healthcare-associated infections are the most common problem in intensive care unit worldwide. Children with congenital heart diseases have many complications such as developmental problems, respiratory tract infections, endocarditis,pneumonia and after long-term hospital and intensive care stays and surgeries patients become vulnerable to healthcare-associated infections. Patients and Methods: The study presents the frequency of infection, microorganisms in patients hospitalized at SBÜ Koşuyolu High Spesialization Research and Training Hospital pediatric cardiovascular surgery intensive care unit between 2016-2020. Results: One hundred-eight HAI episodes were seen in 83 of 1920 patients hospitalized in pediatric cardiovascular surgery intensive care unit between 2016-2020.HAI rates varied between 4.8% and 7.77%. In the 5-year period,a total of 118 different microorganisms were detected.Among all microorganisms, Candida species (n: 43, 36.4%) ranked first. central line-associated bloodstream infections (CLABSI) 53 (49%), ventilator-associated pneumonia (VAP)40 (37%), surgical site infection (SSI) 8 (6.5%), catheter -associated urinary tract infection (CAUTI) 7 (6%) Conclusion: Healthcare-associated infections are require special attention in pediatric cardiovascular intensive care units. In order to prevent, innovations such as bundle applications should be implemented as well as personnel training.

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44. Impact of Nursing Home (NH) Universal Decolonization and COVID Prevention Training on COVID-19 Burden During the 2020-2021 Winter Surge in Orange County (OC), California (CA)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.044 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S32-S32

Author(s):

Gabrielle Gussin ◽

Raveena Singh ◽

Shruti K Gohil ◽

Raheeb Saavedra ◽

Thomas Tjoa ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Training Program ◽

Material Support ◽

Linear Mixed Effects ◽

Cleaning Products ◽

Quasi Experimental ◽

Work Shifts ◽

Prevention Training ◽

The Impact

Abstract Background OC is the 6th largest U.S. county with 70 NHs. Universal decolonization (chlorhexidine for routine bathing, and twice daily nasal iodophor Mon-Fri every other week) was adopted in 24 NHs prior to the COVID-19 pandemic, and 12 NHs (11 of those adopting decolonization) participated in a COVID prevention training program with a rolling launch from July-Sept 2020. We evaluated the impact of these initiatives on staff and resident COVID cases. Methods We conducted a quasi-experimental study of the impact of decolonization and COVID prevention training on staff and resident COVID cases during the CA winter surge (11/16/20-1/31/21), when compared to non-participating NHs. Decolonization NHs received weekly visits for encouraging adherence during the pandemic, and NHs in the COVID training program received 3 in-person training sessions for all work shifts plus weekly feedback about adherence to hand hygiene, masking, and breakroom safety using video monitoring. We calculated incident 1) staff COVID cases, 2) resident COVID cases, and 3) resident COVID deaths adjusting for NH average daily census. We assessed impact of initiatives on these outcomes using linear mixed effects models testing the interaction between any training participation and calendar date when clustering by NH. Because of the overlap of the two initiatives, we evaluated ‘any training’ vs ‘no training.’ Results 63 NHs had available data. 24 adopted universal decolonization, 12 received COVID training (11 of which participated in decolonization), and 38 were not enrolled in either. During the winter surge, the 63 NHs experienced 1867 staff COVID cases, 2186 resident COVID cases, and 251 resident deaths due to COVID, corresponding to 29.6, 34.7, and 4.0 events per NH, respectively. In NHs participating in either initiative, staff COVID cases were reduced by 31% (OR=0.69 (0.52, 0.92), P=0.01), resident COVID cases were reduced by 43% (OR=0.57 (0.39, 0.82), P=0.003), and resident deaths were reduced (non-significantly) by 26% (OR=0.74 (0.46, 1.21), P=0.23). The grey box represents the California COVID-19 winter surge (11/16/20-1/31/21). Incident and cumulative COVID-19 cases and deaths for each nursing home were divided by the nursing home’s average daily census and multiplied by 100, representing events per 100 beds, which were aggregated across groups. Conclusion NHs are vulnerable to COVID-19 outbreaks. A universal decolonization and COVID prevention training initiative in OC, CA significantly reduced staff and resident COVID cases in this high-risk care setting. Disclosures Gabrielle Gussin, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Raveena Singh, MA, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Shruti K. Gohil, MD, MPH, Medline (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnycke (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Raheeb Saavedra, AS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Robert Pedroza, BS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Chase Berman, BS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)

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Costs of ambulatory pediatric healthcare-associated infections: Central-line–associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs)

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.305 ◽

2020 ◽

Vol 41 (11) ◽

pp. 1292-1297

Author(s):

Michael L. Rinke ◽

Suzette O. Oyeku ◽

William J. H. Ford ◽

Moonseong Heo ◽

Lisa Saiman ◽

...

Keyword(s):

Urinary Tract ◽

Ambulatory Surgery ◽

Bloodstream Infections ◽

Surgical Site Infections ◽

Central Line ◽

Healthcare Associated Infections ◽

Retrospective Case ◽

Additional Costs ◽

Tract Infections ◽

Healthcare Associated

AbstractObjective:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery.Design:Retrospective case-control study.Setting:Four academic medical centers.Patients:Children aged 0–22 years seen between 2010 and 2015 and at risk for HAI as identified by electronic queries.Methods:Chart review adjudicated HAIs. Charges were obtained for patients with HAIs and matched controls 30 days before HAI, on the day of, and 30 days after HAI. Charges were converted to costs and 2015 USD. Mixed-effects linear regression was used to estimate the difference-in-differences of HAI case versus control costs in 2 models: unrecorded charge values considered missing and a sensitivity analysis with unrecorded charge considered $0.Results:Our search identified 177 patients with ambulatory CLABSIs, 53 with ambulatory CAUTIs, and 26 with SSIs following ambulatory surgery who were matched with 382, 110, and 75 controls, respectively. Additional cost associated with an ambulatory CLABSI was $5,684 (95% confidence interval [CI], $1,005–$10,362) and $6,502 (95% CI, $2,261–$10,744) in the 2 models; cost associated with a CAUTI was $6,660 (95% CI, $1,055, $12,145) and $2,661 (95% CI, −$431 to $5,753); cost associated with an SSI following ambulatory surgery at 1 institution only was $6,370 (95% CI, $4,022–$8,719).Conclusions:Ambulatory HAI in pediatric patients are associated with significant additional costs. Further work is needed to reduce ambulatory HAIs.

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Infections in Australian Aged-Care Facilities: Evaluating the Impact of Revised McGeer Criteria for Surveillance of Urinary Tract Infections

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.7 ◽

2016 ◽

Vol 37 (5) ◽

pp. 610-612 ◽

Cited By ~ 6

Author(s):

Noleen J. Bennett ◽

Sandra A. Johnson ◽

Michael J. Richards ◽

Mary A. Smith ◽

Leon J. Worth

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Aged Care ◽

Infect Control Hosp ◽

Healthcare Associated Infections ◽

Care Facilities ◽

Aged Care Facilities ◽

Tract Infections ◽

Healthcare Associated ◽

The Impact

Our survey of 112 Australian aged-care facilities demonstrated the prevalence of healthcare-associated infections to be 2.9%. Urinary tract infections (UTIs) defined by McGeer criteria comprised 35% of all clinically defined UTIs. To estimate the infection burden in these facilities where microbiologic testing is not routine, modified surveillance criteria for UTIs are necessary.Infect Control Hosp Epidemiol 2016;37:610–612

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Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs

Infection Control and Hospital Epidemiology ◽

10.1086/657912 ◽

2011 ◽

Vol 32 (2) ◽

pp. 101-114 ◽

Cited By ~ 496

Author(s):

Craig A. Umscheid ◽

Matthew D. Mitchell ◽

Jalpa A. Doshi ◽

Rajender Agarwal ◽

Kendal Williams ◽

...

Keyword(s):

Systematic Review ◽

Bloodstream Infections ◽

Surgical Site Infections ◽

Current Evidence ◽

Annual Number ◽

Evidence Based ◽

Healthcare Associated Infections ◽

Tract Infections ◽

Healthcare Associated ◽

Related Mortality

Objective.To estimate the proportion of healthcare-associated infections (HAIs) in US hospitals that are “reasonably preventable,” along with their related mortality and costs.Methods.To estimate preventability of catheter-associated bloodstream infections (CABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP), we used a federally sponsored systematic review of interventions to reduce HAIs. Ranges of preventability included the lowest and highest risk reductions reported by US studies of “moderate” to “good” quality published in the last 10 years. We used the most recently published national data to determine the annual incidence of HAIs and associated mortality. To estimate incremental cost of HAIs, we performed a systematic review, which included costs from studies in general US patient populations. To calculate ranges for the annual number of preventable infections and deaths and annual costs, we multiplied our infection, mortality, and cost figures with our ranges of preventability for each HAI.Results.AS many as 65%–70% of cases of CABSI and CAUTI and 55% of cases of VAP and SSI may be preventable with current evidence-based strategies. CAUTI may be the most preventable HAI. CABSI has the highest number of preventable deaths, followed by VAP. CABSI also has the highest cost impact; costs due to preventable cases of VAP, CAUTI, and SSI are likely less.Conclusions.Our findings suggest that 100% prevention of HAIs may not be attainable with current evidence-based prevention strategies; however, comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.

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Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211067930 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110679

Author(s):

Hela Ghali ◽

Asma Ben Cheikh ◽

Sana Bhiri ◽

Selwa Khefacha ◽

Houyem Said Latiri ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Protective Factor ◽

Bloodstream Infections ◽

Point Prevalence ◽

University Hospital ◽

Healthcare Associated Infection ◽

Tract Infections ◽

Healthcare Associated ◽

The Impact

Background Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. Aim To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. Methods The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Results Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% ( P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Conclusion Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

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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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.362 ◽

2021 ◽

pp. 1-14 ◽

Cited By ~ 1

Author(s):

Lindsey M. Weiner-Lastinger ◽

Vaishnavi Pattabiraman ◽

Rebecca Y. Konnor ◽

Prachi R. Patel ◽

Emily Wong ◽

...

Keyword(s):

State Level ◽

Bloodstream Infections ◽

Surgical Site Infections ◽

Infection Prevention And Control ◽

Healthcare Associated Infection ◽

National Healthcare ◽

National Healthcare Safety Network ◽

Tract Infections ◽

Healthcare Associated ◽

The Impact

Abstract Objectives: To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Methods: Central–line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), select surgical site infections, and Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events reported to the National Healthcare Safety Network for 2019 and 2020 by acute-care hospitals were analyzed. SIRs were calculated for each HAI and quarter by dividing the number of reported infections by the number of predicted infections, calculated using 2015 national baseline data. Percentage changes between 2019 and 2020 SIRs were calculated. Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were also performed. Results: Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Changes in the SIR varied by quarter and state. The largest increase was observed for CLABSI, and significant increases in VAE incidence and ventilator utilization were seen across all 4 quarters of 2020. Conclusions: This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.

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Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Poland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15091956 ◽

2018 ◽

Vol 15 (9) ◽

pp. 1956 ◽

Cited By ~ 6

Author(s):

Małgorzata Kołpa ◽

Marta Wałaszek ◽

Anna Różańska ◽

Zdzisław Wolak ◽

Jadwiga Wójkowska-Mach

Keyword(s):

Bloodstream Infections ◽

Surgical Site Infections ◽

Etiologic Agent ◽

Healthcare Associated Infections ◽

Gastrointestinal Infections ◽

Surveillance Network ◽

Surgical Units ◽

Improve Compliance ◽

Tract Infections ◽

Healthcare Associated

Healthcare-associated infections (HAIs) are adverse complications of hospitalisation resulting in delayed recovery and increased costs. The aim of this study was an analysis of epidemiological factors obtained in the framework of constant, comprehensive (hospital-wide) infection registration, and identification of priorities and needs in infection control, both with regard to targeted surveillance, as well as preventative actions. The study was carried out according to the methodology recommended by the HAI-Net (Surveillance Network) coordinated by the European Centre for Disease Prevention and Control, in the multiprofile hospital in Southern Poland, between 2012 and 2016. A total of 159,028 patients were under observation and 2184 HAIs were detected. The incidence was 1.4/100 admissions (2.7/1000 patient-das of hospitalisation) and significantly differed depending on the type of the patient care: in intensive care units (ICU) 16.9%; in surgical units, 1.3%; non-surgical units, 1.0%; and paediatric units, 1.8%. The most common HAI was gastrointestinal infections (GIs, 28.9%), followed by surgical site infections (SSIs, 23.0%) and bloodstream infections (BSIs, 16.1%). The vast majority of GIs, BSIs, urinary tract infections, and incidents of pneumonia (PN) were detected in non-ICUs. As many as 33.2% of cases of HAI were not confirmed microbiologically. The most frequently detected etiologic agent of infections was Clostridium difficile—globally and in GI (49%). Comprehensive analysis of the results allowed to identify important elements of surveillance of infections, i.e., surveillance of GI, PN, and BSI not only in ICU, but also in non-ICU wards, indicating a need for implementing rapid actions to improve compliance with HAI prevention procedures.

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Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt

Infection Control and Hospital Epidemiology ◽

10.1086/673985 ◽

2013 ◽

Vol 34 (12) ◽

pp. 1281-1288 ◽

Cited By ~ 13

Author(s):

Isaac See ◽

Fernanda C. Lessa ◽

Omar Abo ElAta ◽

Soad Hafez ◽

Karim Samy ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Clinical Symptoms ◽

Case Fatality ◽

Bloodstream Infections ◽

Reference Laboratory ◽

Healthcare Associated Infections ◽

International Consensus ◽

Convenience Sample ◽

Tract Infections ◽

Healthcare Associated

Objective.To report type and rates of healthcare-associated infections (HAIs) as well as pathogen distribution and antimicrobial resistance patterns from a pilot HAI surveillance system in Egypt.Methods.Prospective surveillance was conducted from April 2011 through March 2012 in 46 intensive care units (ICUs) in Egypt. Definitions were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Trained healthcare workers identified HAIs and recorded data on clinical symptoms and up to 4 pathogens. A convenience sample of clinical isolates was tested for antimicrobial resistance at a central reference laboratory. Multidrug resistance was defined by international consensus criteria.Results.ICUs from 11 hospitals collected 90,515 patient-days of surveillance data. Of 472 HAIs identified, 47% were pneumonia, 22% were bloodstream infections, and 15% were urinary tract infections; case fatality among HAI case patients was 43%. The highest rate of device-associated infections was reported for ventilator-associated pneumonia (pooled mean rate, 7.47 cases per 1,000 ventilator-days). The most common pathogens reported were Acinetobacter species (21.8%) and Klebsiella species (18.4%). All Acinetobacter isolates tested (31/31) were multidrug resistant, and 71% (17/24) of Klebsiella pneumoniae isolates were extended-spectrum β-lactamase producers.Conclusions.Infection control priorities in Egypt should include preventing pneumonia and preventing infections due to antimicrobial-resistant pathogens.

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