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Infect Control Hosp Epidemiol . Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infect

tetano

Editor, Senior Moderator
Infect Control Hosp Epidemiol


. 2023 Jun 29;1-6.
doi: 10.1017/ice.2023.83. Online ahead of print. Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infections in hospitalized patients

Trevor S Farthing[SUP] 1 [/SUP], Ashlan Jolley[SUP] 1 [/SUP], Katelin B Nickel[SUP] 2 [/SUP], Cherie Hill[SUP] 2 [/SUP], Dustin Stwalley[SUP] 2 [/SUP], Kimberly A Reske[SUP] 2 [/SUP], Jennie H Kwon[SUP] 2 [/SUP], Margaret A Olsen[SUP] 2 [/SUP], Jason P Burnham[SUP] 2 [/SUP], Erik R Dubberke[SUP] 2 [/SUP], Cristina Lanzas[SUP] 1 [/SUP]; CDC Modeling Infectious Disease in Healthcare Program



Affiliations
Abstract

Objective: We compared the individual-level risk of hospital-onset infections with multidrug-resistant organisms (MDROs) in hospitalized patients prior to and during the coronavirus disease 2019 (COVID-19) pandemic. We also quantified the effects of COVID-19 diagnoses and intrahospital COVID-19 burden on subsequent MDRO infection risk.
Design: Multicenter, retrospective, cohort study.
Setting: Patient admission and clinical data were collected from 4 hospitals in the St. Louis area.
Patients: Data were collected for patients admitted between January 2017 and August 2020, discharged no later than September 2020, and hospitalized ≥48 hours.
Methods: Mixed-effects logistic regression models were fit to the data to estimate patients' individual-level risk of infection with MDRO pathogens of interest during hospitalization. Adjusted odds ratios were derived from regression models to quantify the effects of the COVID-19 period, COVID-19 diagnosis, and hospital-level COVID-19 burden on individual-level hospital-onset MDRO infection probabilities.
Results: We calculated adjusted odds ratios for COVID-19-era hospital-onset Acinetobacter spp., P. aeruginosa and Enterobacteriaceae spp infections. Probabilities increased 2.64 (95% confidence interval [CI], 1.22-5.73) times, 1.44 (95% CI, 1.03-2.02) times, and 1.25 (95% CI, 1.00-1.58) times relative to the prepandemic period, respectively. COVID-19 patients were 4.18 (95% CI, 1.98-8.81) times more likely to acquire hospital-onset MDRO S. aureus infections.
Conclusions: Our results support the growing body of evidence indicating that the COVID-19 pandemic has increased hospital-onset MDRO infections.


 
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