Dataset Information

Impact of the coronavirus disease 2019 pandemic on healthcare-associated infections at intensive care units in South Korea: Data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS)

ABSTRACT:

Background

The coronavirus disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. The impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in intensive care units (ICUs) was evaluated.

Methods

A retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System was conducted. Comparisons between incidence rates and microorganism distributions of bloodstream infections (BSIs), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated pneumonia (VAP) before and during the COVID-19 pandemic were performed according to hospital size.

Results

The incidence rate of BSI significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period (1.38 vs. 1.23 per 10,000 patient-days, relative change -11.5%; P<0.001). The incidence rate of VAP (1.03 vs. 0.81 per 1,000 device-days, relative change -21.4%; P<0.001) significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period, whereas that rates of CLABSIs (2.30 vs. 2.23 per 1,000 device-days; P=0.19) and CAUTIs (1.26 vs. 1.26 per 1,000 device-days; P=0.99) were similar between the two periods. The rates of BSIs and CLABSIs significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates significantly decreased in small to medium-sized hospitals. The rates of CAUTI and VAP significantly decreased in small-sized hospitals. There were no significant changing trends in the rates of multidrug-resistant pathogens isolated from patients with HAIs between the two periods.

Conclusion

The incidence rates of BSI and VAP in ICUs decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. This decrease was mainly seen in small to medium-sized hospitals.

SUBMITTER: Lee Y

PROVIDER: S-EPMC10239201 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Project description:BackgroundHealthcare-associated infections (HAIs) represent serious complications for patients within pediatric cardiac intensive care units (CICU). HAIs are associated with increased morbidity, mortality and resource utilization. There are few studies describing the epidemiology of HAIs across the entire spectrum of patients (surgical and nonsurgical) receiving care in dedicated pediatric CICUs.MethodsRetrospective analyses of 22,839 CICU encounters from October 2013 to September 2016 across 22 North American CICUs contributing data to the Pediatric Cardiac Critical Care Consortium clinical registry.ResultsHAIs occurred in 2.4% of CICU encounters at a rate of 3.3 HAIs/1000 CICU days, with 73% of HAIs occurring in children <1 year. Eighty encounters (14%) had ≥2 HAIs. Aggregate rates for the 4 primary HAIs are as follows: central line-associated blood stream infection, 1.1/1000 line days; catheter-associated urinary tract infections, 1.5/1000 catheter days; ventilator-associated pneumonia, 1.9/1000 ventilator days; surgical site infections, 0.81/100 operations. Surgical and nonsurgical patients had similar HAIs rates/1000 CICU days. Incidence was twice as high in surgical encounters and increased with surgical complexity; postoperative infection occurred in 2.8% of encounters. Prematurity, younger age, presence of congenital anomaly, Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Categories (STAT) 4-5 surgery, admission with an active medical condition, open sternum and extracorporeal membrane oxygenation were independently associated with HAIs. In univariable analysis, HAI was associated with longer hospital length of stay and durations of urinary catheter, central venous catheter and ventilation. Mortality was 24.4% in patients with HAIs versus 3.4% in those without, P < 0.0001.ConclusionsWe provide comprehensive multicenter benchmark data regarding rates of HAIs within dedicated pediatric CICUs. We confirm that although rare, HAIs of all types are associated with significant resource utilization and mortality.