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Exploring the Correlation Between the COVID-19 Pandemic, Race and Central Line Associated Bloodstream Infections

In the advent of the COVID-19 pandemic, there has been a significant surge in central line-associated bloodstream infections (CLABSI) which raised alarms among healthcare professionals. Understanding the factors contributing to this alarming trend was, however, not well-established. In response to this challenge, investigators connected to Advocate Health, based in Charlotte, NC, conducted a comprehensive study to determine which elements, including race, directly influenced the rise of CLABSI during the pandemic.

The investigators carried out a retrospective cohort study spanning from 2019 to 2021 across 11 acutely managed hospitals in southeast US. This research window comprised of two critical periods: the pre-pandemic phase which was from 1st January 2019 to 29th February 2020, and the pandemic phase which began from 1st March 2020 and ended on 31st December 2021. Information gathered included aspects such as self-declared race and ethnicity, medical histories, COVID-19 status, and specifics relating to the central line.

The study unveiled a significant increase in the proportion of CLABSI cases, identifying 313 instances from a pool of 46,259 central line patients. Of these, 109 cases were documented in the pre-pandemic phase, with the figure ballooning to 204 instances during the pandemic. It was found that among the pre-pandemic risk factors were elements like cancer diagnosis, hospital stay while receiving total peripheral nutrition (TPN), engaging in an intensive care unit encounter, alongside an extended duration of stay and average line days.

In an intriguing revelation, the research demonstrated a higher risk of developing CLABSI among Black patients during the pandemic—a trend that was not in evidence before. Notably, Black patients without a COVID-19 diagnosis were about 1.6 times more likely to contract CLABSI than their White counterparts. Other risk factors that surfaced during the study comprised medical insurance under Medicare, the presence of a dialysis catheter and a higher body mass index.

Catherine Passaretti, MD, vice president and Southeast Region epidemiologist at Advocate Health, suggests that healthcare strains during the pandemic might have inadvertently inflated these risk factors. She postulates that an understanding of how stress and burnout affect healthcare behaviors and measures to solidify basic practices amid stressful periods could be beneficial in combating such healthcare crises.

Finally, a discussion on the decreases in Hospital Acquired Infections (HAIs) in hospitals and the multidisciplinary collaboration’s role in UTI management laid the foundation for creating best practices during times of crisis in the healthcare sector.


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