The Impact of COVID-19 Outbreak on Nosocomial Infection Rate: A Case of Iran

Background. Coronavirus disease-19 (COVID-19) is a new type of coronavirus that has caused a global pandemic. The disease is highly contagious, and all people are susceptible to the disease. Therefore, extensive measures were taken to prevent the spread of the disease at the community and hospitals. This study aimed to investigate the impact of COVID-19 outbreak on nosocomial infection rate. Methods. This cross-sectional study was conducted in an educational hospital, southeast Iran. The nosocomial infection rates of critical/intensive care units (CCU/ICUs) and medical-surgical units were assessed during and before the COVID-19 outbreak. Results. There was a 19.75-point decrease in the total rate of nosocomial infection during the COVID-19 outbreak ( P = 0.02). In addition, there was a 39.12-point decrease in the total rate of CCU/ICUs’ nosocomial infection during the COVID-19 outbreak ( P < 0.001). A 19.23-point decrease was also observed in the total rate of medical-surgical units’ nosocomial infection during the COVID-19 outbreak ( P = 0.13). All kinds of CCU/ICUs’ nosocomial infections had between 31.22- and 100-point decreases during the COVID-19 outbreak. Among medical-surgical units, 33.33- and 30.70-point decreases were observed only in UTI and SSI, respectively, during the COVID-19 outbreak, while BSI had a 40-point increase during the COVID-19 outbreak. Conclusions. Proper implementation of infection control protocols during the COVID-19 pandemic seems to reduce nosocomial infections.

807. Effect of Inter-Hospital Transfer on Nosocomial Infection Rates in Patients Receiving Extracorporeal Membrane Oxygenation

Background Extracorporeal Oxygenation (ECMO) has been increasingly used as a life support modality for cardiac and pulmonary failure. Due to improved survival in patients treated in high volume ECMO centers, inter-hospital transport of these critically ill patients is on the rise. These patients may be transported via ambulance locally, or by aircraft over long distances. However, potential risks of nosocomial infectious complications associated with transfers has not been reported. We evaluated the impact of transfers on nosocomial infections for patients who received ECMO at Brooke Army Medical Center (BAMC). Methods All patients who received ECMO for ≥48 hours at BAMC between May 2012 and October 2019 were included. Chart review was performed to determine transport status, infectious complications while on ECMO, and antimicrobial susceptibility of isolated organisms. Statistical analyses were performed using Chi-squared, Fisher’s exact, or Mann-Whitney U tests as appropriate. Factors associated with nosocomial infections were evaluated by multivariate logistic regression. Results Compared to patients who were cannulated locally (n=33), patients who underwent cannulation at referral facility and inter-hospital transfer (n=76) had no difference in infections per 1000 ECMO days (33.1 vs. 30.5, p=0.74) or in infections with multidrug resistant organisms (MDRO) (50% vs. 55%, p=1). Of transferred patients, those transferred by aircraft (n=11) had no difference in infection rate (22.4 vs. 31.8 per 1000 ECMO days, p= 0.39) or MDRO incidence (52% vs 75%, p=0.61) compared to those only transferred by ambulance (n=65). Multivariate analysis showed the greatest risk factor for nosocomial infection was time on ECMO (OR 12.2 for longest tertile time on ECMO vs. shortest tertile, p=0.0001); transport was not significantly associated with infection (OR 2.1, p=0.06). Nosocomial infection rate by site of ECMO cannulation Conclusion This study did not find a significant difference in nosocomial infection rate or recovery of MDROs between transported and non-transported patients on ECMO, regardless of transport modality. This study suggests that transportation is not the primary driver of nosocomial infections in this cohort. Disclosures All Authors: No reported disclosures

Effect of Nursing Quality Management on the Nosocomial Infection Rate and Psychology State of Patients with Burn and Plastic Surgery

Background: To explore the effect of nursing quality management on the nosocomial infection rate and Psychology State of patients with burn and plastic surgery. Methods: Overall, 92 patients with burn and plastic surgery admitted to Qilu Hospital, Jinan, China from Apr 2017 to Jul 2018 were selected, in which 46 cases were randomly selected as a control group for routine nursing management, and another 46 cases as a research group to strengthen nursing quality management. The incidence of nosocomial infection, nursing satisfaction and nurse-patient disputes were compared. MMAS-8 scale was used to compare the compliance of the two groups. SAS and SDS score were used to compare the psychological status. The recovery and discharge were compared. Results: The incidence of nosocomial infection in the study group was significantly lower than that in the control group (P<0.05). The total satisfaction rate of the study group was significantly higher than that of the control group (P<0.05). The incidence of nurses-patients disputes was significantly lower than that of the control group. The SAS and SDS score of the study group were significantly better than the control group (P<0.05). The healing time, blood circulation recovery time of skin wounds and discharge time in the study group were significantly better than those in the control group. Conclusion: Strengthening nursing quality management can effectively reduce the nosocomial infection rate of burn and plastic surgery. It helps to further accelerate the recovery of patients and make patients ’psychological state better.

Risk Factors and Prevention Strategies of Nosocomial Infection in Geriatric Patients

Introduction. To investigate the risk factors of nosocomial infections (NIs) in geriatric department and the effectiveness of the proposed prevention strategy. Methodology. We studied 3370 cases of elderly patients who were hospitalized more than 48 hours from January 2015 to December 2017 in the Geriatrics Department of Zhongda Hospital, Southeast University. In order to reduce the infection rate, nutritional risk screening (NRS 2002) was used to evaluate the nutritional status of the patients; enteral nutritional suspension (TPF-FOS) was provided to the patients who were assessed to be necessary. Results. Before prevention strategy was taken, the nosocomial infection rate was 3.3% (80 among 2413 patients) in our department. The most frequent NIs were pneumonia (60 cases) followed by urinary tract infection (30 cases). It is worth noting that the elderly patients are often associated with multiple infections: in our study, 15 patients have pneumonia and UTI at the same time. After prevention strategy was taken, the nosocomial infection rate reduced to 1.15% (11 among 957 patients) in our department. Conclusions. NIs are common in elderly patients. The improvement of the nutritional status of patients is effective in reducing the risks of NIs.