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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Pandemic Crushes Healthcare Infection Gains

By Gary Evans, Medical Writer

Years of steady, incremental reductions in healthcare-associated infections (HAIs) were dashed by the tsunami of the COVID-19 pandemic, the Centers for Disease Control and Prevention reports.

Data from the CDC’s National Healthcare Safety Network revealed that four important HAIs — including central line-associated bloodstream infections (CLABSIs) — were much higher in 2020 than in 2019. The rate of CLABSIs — which have a mortality rate in the 20% range — were some 47% higher than 2019 in the third and fourth quarters of 2020.

Likewise, catheter-associated urinary tract infections, ventilator-associated events, and antibiotic-resistant staph infections also prospered during the chaos of the pandemic.

The CDC has been working with hospital infection preventionists for years to keep these infections at bay, but the pandemic was the proverbial “perfect storm,” says Arjun Srinivasan, MD, CDC’s associate director of HAI Prevention Programs. “This [information] emphasizes the importance of building stronger, deeper, and broader infection control resources throughout healthcare.”

In addition to having no vaccine as the pandemic hit, healthcare settings had shortages of personal protective equipment and confusing, seemingly constantly changing guidelines as the CDC grappled with the rapid spread of SARS-CoV-2. It is not clear how much the rising infections occurred among COVID-19 patients or contributed to the substantial and excess mortality in 2020. Though the data are difficult to winnow out, it’s clear the pandemic and increased HAIs are directly related.

For example, with surging use of ventilators for COVID-19 patients, ventilator-associated infections increased by 45% in 2020 compared to 2019.

The study found that two other types of HAIs remained steady or declined during COVID-19. These included surgical-site infections, which dropped as fewer elective surgeries were performed. More surprisingly, rates of Clostridioides difficile, went down or stayed about even, possibly due to the greater attention on hand hygiene, environmental cleaning, patient isolation, and use of PPE during the pandemic.

For more on this story, see the next issue of Hospital Infection Control & Prevention.