Abstract
To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), select surgical site infections, and Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events reported to the National Healthcare Safety Network for 2019 and 2020 by acute-care hospitals were analyzed. SIRs were calculated for each HAI and quarter by dividing the number of reported infections by the number of predicted infections, calculated using 2015 national baseline data. Percentage changes between 2019 and 2020 SIRs were calculated. Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were also performed. Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Changes in the SIR varied by quarter and state. The largest increase was observed for CLABSI, and significant increases in VAE incidence and ventilator utilization were seen across all 4 quarters of 2020. This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.
Highlights
Larger declines in the number of reporting hospitals were seen for ventilator-associated events (VAEs) (22 – 25% drop) and surgical site infections (SSIs) (25%–36% drop) surveillance
The increases in the central-line–associated bloodstream infections (CLABSIs) standardized infection ratio (SIR) were driven by larger SIR numerators in 2020; for example, in 2020-Q3, there were 4,460 CLABSIs reported, representing a 53% increase compared to the 2,911 events reported from the same hospitals and locations in 2019-Q3
We detected no significant increases in the national quarterly SIRs for SSI or Clostridioides difficile infection (CDI) for any quarter in 2020 compared to 2019
Summary
To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Percentage changes between 2019 and 2020 SIRs were calculated Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were performed. Results: Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Conclusions: This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics. (Received 12 July 2021; accepted 15 July 2021)
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