COVID-related challenges likely hindered implementation and effectiveness of infection prevention protocols in hospitals . The findings highlight the importance of healthcare infection control as one of the foremost tools needed to address emerging infectious diseases .” — Margaret Dudeck , MPH
dramatic increases , understanding , of course , that some of this is due to worsening respiratory status in patients with COVID-19 and a higher morbidity of patients than in 2019 . Looking at preliminary 2022 Q2 data , we are seeing the same sort of trend with these HAIs along with the COVID hospitalizations . I think the Q2 data are promising right now , but we obviously still have a ways to go and understand how those will progress .”
Dudeck pointed to near-future NHSN initiatives that the CDC hopes will provide a greater understanding of factors that may influence HAIs and other patient-centered outcomes . These include :
●Transitioning hospital capacity and COVID-19 related hospitalization data to NHSN ( and the need for a single system that can measure the impact of a public health emergency on patient-safety issues )
●Exploring the use of nurse staffing as a structural factor to understand healthcare resiliency
●Heightened need for patient-level data using accepted data exchange standards
●Evaluating the need for updated risk adjustment based on current rates and recent factors that may impact HAIs
Dudeck emphasized the need to strengthen and build resiliency in our infection prevention programs to withstand future pandemics and maintain national prevention progress .
She pointed to the significant increases in the major HAIs and that these increases were tied to high numbers of COVID-19 hospitalizations , particularly in 2021 . These national results are similar to the findings of other studies highlighting HAI increases alongside increased CIVID admissions and changes in hospital and infection prevention practices . Dudek also said that factors included increased length of stay , an increased number of patients , staffing shortages , changes in antibiotic use , and departures from standard infection prevention and control practices due to the pandemic .
“ COVID-related challenges likely hindered implementation and effectiveness of infection prevention protocols in hospitals ,” Dudeck said , emphasizing that “ the findings highlight the importance of healthcare infection control as one of the foremost tools needed to address emerging infectious diseases .”
The recently released 2021 National and State Healthcare-Associated Infections Progress Report represents a return to more normalized infection reporting to the NHSN .
As we have seen , compared to pre-pandemic years , hospitals across the nation experienced higher than usual hospitalizations and shortages in healthcare personnel and equipment , which may have resulted in deterioration in
multiple patient safety metrics since the beginning of the pandemic , the CDC acknowledges . In 2021 , hospitals resumed mandated reporting for HAIs as the previously implemented extraordinary circumstance exception ( ECE ) policy ended with 2020 Q2 data . As a result , the number of facilities reporting HAIs via NHSN returned to the pre-pandemic numbers in 2021 after a decline in 2020 .
Findings from a review of the quarterly 2021 NHSN data compared with 2019 showed continued increases in 2021 in the quarterly SIRs for CLABSI , CAUTI , VAE , and MRSA bacteremia , the CDC reports . Despite a decrease in the SIR for 2021 Q2 compared to the preceding quarter , the SIRs for CLABSI , VAE , and MRSA bacteremia remained higher than in 2019 Q2 . The 2021 quarterly SIRs for CDI showed significant decreases and the SSI-COLO , SSI-HYST SIRs remained largely unchanged .
The results of the SIR analyses on an annual basis are parallel to the results of the quarterly analyses summarized above with the comparison year in the Progress Report is the year 2020 . As with the quarterly SIR analyses , significant increases are observed for acute-care facilities in the 2021 annual SIRs for CLABSI , CAUTI , MRSA , and VAE when compared with 2020 . A significant decrease was observed in the C . difficile national SIR . In addition , the annual report found no significant change in the SSI in 2021 following colon surgery . Overall , the report shows a significant increase in SSIs in 2021 following abdominal hysterectomy when compared with 2020 . Nationally , among acute-care hospitals for 2021 :
●Overall , 7 % increase in CLABSI between 2020 and 2021
• Largest increase in ICUs ( 10 %) ●Overall , 5 % increase in CAUTI between 2020 and 2021
• Largest increase in ICUs ( 9 %) ●Overall , there was a 12 % increase in VAE between 2020 and 2021
• Observed a 12 % increase in ICUs
• Observed a 16 % increase in non-ICUs
●Overall , there were no significant changes in SSI related to the 10 select procedures tracked in the report between 2020 and 2021 .
The 10 select procedures are Surgical Care Improvement Project ( SCIP ) procedures .
• Observed an 11 % increase in abdominal hysterectomy
SSIs
• No significant changes in colon surgery SSIs
• There was 14 % increase in hospital onset MRSA bacteremia between 2020 and 2021
• There was a 3 % decrease in hospital onset C . difficile infections between 2020 and 2021
• • •
In his IDWeek presentation as part of the “ What the Big Beasts of Hospital Epidemiology and Antimicrobial Stewardship Did During COVID-19 ,” Robert Bonomo , MD , associate chief of staff for academic affairs at Case Western Reserve University / Louis Stokes Cleveland VA Medical Center reviewed pandemic history .
“ Even though we are in another pandemic , this is not our first rodeo ,” he said . “ As a civilization , we ’ ve been here before based on history and we still have a lot to learn about pandemics . The question is , why did this happen ? Why are we in a pandemic now ? I want you to think about the evolution of these issues and how we come to understand their origins . Change brings the