This post outlines the findings of a recent study by The University of Texas MD Anderson Cancer Center into the impact of COVID-19 precautions on healthcare-associated infections (HAIs). Many studies have assessed changes in these infections during the pandemic, but the novel study presented isolates the incidence date of HAIs, central line-associated bloodstream infections (CLABSIs), multidrug-resistant organisms (MDROs), and several others in different wards of the center.
Amy Spallone, MD, Assistant Professor of infectious diseases in Infection Control and Employee Health at MD Anderson Cancer Center, elaborates on the findings, which were published in the American Journal of Infection Control.
The pandemic brought about swift changes to institutional protocols for protecting patients and staff, prompting an investigation into changes to HAI rates. By comparing HAI rates before and after the pandemic and evaluating enhanced Infection prevention and control (IPC) measures, the objective was to understand their effects on HAI rates among approximately 30,000 patients. Enhanced IPC measures included high-volume COVID-19 testing, ensuring a reliable PPE supply chain, mandatory masking, controlling access and visitor numbers to the medical campus, and creating dedicated COVID-19 units and pathways. While CLABSI and CDI rates significantly decreased, MDRO rates increased five-fold within COVID-19 wards. Also, there was a notable reduction in total respiratory viral infections (RVI), attributable to PPE use, hand hygiene compliance, and decreased visitor traffic.
The study found lower incidence rates for CLABSI, healthcare facility-onset C difficile infection, and total respiratory viral infections compared to the pre-pandemic era. These rates contrast with other centers, where CLABSI rates increased during the pandemic. Amid stable MDRO rates center-wide, there was an uptick with cohorted patients in the COVID-19 unit, potentially due to increased IV antibiotic use. Despite thesepatients’ isolation and limited interaction with staff and visitors, the higher MDRO rates seen are not necessarily due to IPC measures.
Regarding the sharp decrease in CLABSI rates, Spallone highlights the decisive role of consistent adherence to CLABSI bundle protocols by the highly trained and educated care teams. The pandemic did not impede access to vital PPE, ensuring proper maintenance of central lines according to hospital policy. The low staff turnover rates and continued educational emphasis were the backbone of achieving this level of adherence. Finally, the post discusses a variety of other critical issues related to infection prevention, such as the burden of COVID-19 on immunocompromised individuals, education requirements for infection preventionists, and leveraging building information modeling for better infection control in health care facility development.