Community-onset and hospital-acquired COVID-19 infections demonstrated a significant relationship, according to a pivotal study published in the JAMA Network Open. The findings cumulate from an expansive two-year cohort study spanning from July 2020 to June 2022, that scrutinized COVID-19 hospitalizations, hospital-acquired infection (HAI) rates, testing protocols, and hospital features nationwide during variable phases of the pandemic. The research insinuated an urgent need for heightened surveillance and infection prevention protocols in hospitals, particularly when community-onset infection rates are soaring.
The study considered only those hospitals that had adequate laboratory data on admitted COVID-19 patients, including at least one SARS-CoV-2 test result. The data comprised details on monthly patient discharges and corresponding SARS-CoV-2 test results for months having sufficient laboratory data. By employing multivariable generalized estimating equation negative-binomial regression models, the researchers closely examined the associations between monthly HAI rates (per 1000 patient-days), and variables like variant-specific pandemic periods, admission testing rates, and diverse hospital characteristics.
Roughly 4.4 million COVID-19 hospitalizations fell under the study’s purview, out of which around 91.8% were classified as community-onset – denoting a positive SARS-CoV-2 test result within a week prior to or three days post-admission. A lesser 4.4% and 3.8% of the cases were classified as hospital-acquired or indeterminate onset infections, respectively. An alarming uptick in HAI coincided with a surge in cases classed as community-onset or indeterminate onset.
The researchers revealed HAI rates to have escalated by 178% for every 10% amplification in the rate of community-onset infections, even subsequent to adjustments for factors like predominant variant period, admission testing rates, hospital bed size, and geographical location. Surprisingly, hospital features like patient demographic, geographic location, and teaching status showed no significant association with HAI rates.
However, the study has its limitations including potential misclassifications of COVID-19 infection origin, the incapability to accurately ascertain infection onset timing, and contaminants in the form of differences in individual hospital testing practices and infection control procedures. Increasing efforts are required to establish effective strategies to avert the in-hospital transmission of the SARS-CoV-2 virus according to the researchers.
Source: https://www.infectiousdiseaseadvisor.com/home/topics/covid19/hospital-acquired-covid19-rates-high-when-community-onset-rates-are-high/