Healthcare-associated infections in Veterans Affairs acute-care and long-term healthcare facilities during the coronavirus disease 2019 (COVID-19) pandemic
Healthcare-associated infections in Veterans Affairs acute-care and long-term healthcare facilities during the coronavirus disease 2019 (COVID-19) pandemic
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DOI：
10.1017/ice.2022.93
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发表时间：
2022-04-05
影响因子：
4.5
通讯作者：
Roselle, Gary A.
中科院分区：
文献类型：
--
作者：
Evans, Martin E.;Simbartl, Loretta A.;Roselle, Gary A.
目的：评估2019冠状病毒病（COVID-19）大流行对128家急性护理和132家长期护理退伍军人事务部（VA）机构报告的医疗相关感染（HAI）的影响。研究方法：我们比较了中心静脉导管相关血流感染（CLABSI）、呼吸机相关事件（VAE）、导管相关尿路感染（CUTI）、耐甲氧西林金黄色葡萄球菌（MRSA）、在大流行之前，每个设施每月向中央数据库报告的艰难梭菌感染和比率（2019年2月至2020年1月）和大流行期间（2020年7月至2021年6月）。结果：全国VA COVID-19入院人数于2021年1月达到峰值。在大流行期间，在急性护理机构中观察到CLABSI、VAE和MRSA所有部位HAI（但不是MRSA CLABSI）的发生率显著增加。CRTI率无显著变化，C。艰难率显著降低。长期护理设施中的HAI没有显著增加。结论：COVID-19大流行对VA急性护理中各种类型的HAI产生了不同的影响，许多比率都有所增加。CDI HAI的减少可能部分是由于诊断测试的发展。COVID-19对退伍军人事务部长期设施的影响甚微，可能反映出患者人数和病情的差异，以及对大流行对疗养院居民影响的早期认识，从而提高了对该环境的警惕并优化了感染预防和控制措施。这些数据支持在大流行之前和期间建立和维持常规感染预防和控制战略的必要性。
Objective: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infections (HAIs) reported from 128 acute-care and 132 long-term care Veterans Affairs (VA) facilities. Methods: We compared central-line-associated bloodstream infections (CLABSIs), ventilator-associated events (VAEs), catheter-associated urinary tract infections (CAUTIs), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridioides difficile infections and rates reported from each facility monthly to a centralized database before the pandemic (February 2019 through January 2020) and during the pandemic (July 2020 through June 2021). Results: Nationwide VA COVID-19 admissions peaked in January 2021. Significant increases in the rates of CLABSIs, VAEs, and MRSA all-site HAIs (but not MRSA CLABSIs) were observed during the pandemic in acute-care facilities. There was no significant change in CAUTI rates, and C. difficile rates significantly decreased. There were no significant increases in HAIs in long-term care facilities. Conclusions: The COVID-19 pandemic had a differential impact on HAIs of various types in VA acute care, with many rates increasing. The decrease in CDI HAIs may be due, in part, to evolving diagnostic testing. The minimal impact of COVID-19 in VA long-term facilities may reflect differences in patient numbers and acuity and early recognition of the impact of the pandemic on nursing home residents leading to increased vigilance and optimization of infection prevention and control practices in that setting. These data support the need for building and sustaining conventional infection prevention and control strategies before and during a pandemic.