Surging CLABSI rates during the COVID-19 Pandemic

Reviewed by Rebekah Moehring, MD, MPH, FSHEA, Duke University

Two recent publications in Infection Control & Hospital Epidemiology reported central line-associated bloodstream infection (CLABSI) rates in US hospitals increased during the early phases of the COVID-19 pandemic. At 78 hospitals in the Ascension health system, CLABSI increased by 51% during the first 6 months of the pandemic compared to the 12 months prior. Increases were also seen in a second analysis of NHSN CLABSI SIRs including 936 hospitals: a 28% (95% CI: 20-33.6%) increase was observed in quarter 2 of 2020 compared to quarter 2 of 2019. Drivers of these observations are likely multifactorial and have yet to be fully defined, possibly including increases in device utilization, reduced contact between staff and isolated patients, increased use of prone positioning in ICUs, and an overall increase in patient complexity and acuity. Increased events due to coagulase-negative Staphylococci suggest many events were likely preventable and that pandemic conditions may have led to lapses in infection prevention best practices.

References:

Patel, P., Weiner-Lastinger, L., Dudeck, M., Fike, L., Kuhar, D., Edwards, J., . . . Benin, A. (2021). Impact of COVID-19 Pandemic on Central Line-Associated Bloodstream Infections During the Early Months of 2020, National Healthcare Safety Network. Infection Control & Hospital Epidemiology, 1-8. doi:10.1017/ice.2021.108

Fakih, M., Bufalino, A., Sturm, L., Huang, R., Ottenbacher, A., Saake, K., . . . Cacchione, J. (2021). Coronavirus disease 2019 (COVID-19) pandemic, central-line‚Äďassociated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): The urgent need to refocus on hardwiring prevention efforts. Infection Control & Hospital Epidemiology, 1-6. doi:10.1017/ice.2021.70

https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/covid19-pandemic-clabsi-and-cauti-the-urgent-need-to-refocus-on-hardwiring-prevention-efforts/AB369E693CE1532E91721345384ACAE6

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