Healthcare-associated infections in Dutch hospitals during the COVID-19 pandemic

Abstract

Background During the COVID-19 pandemic hospitals reorganized their resources and delivery of care, which may have affected the number of healthcare-associated infections (HAIs). We aimed to quantify changes in trends in the number of HAIs in Dutch hospitals during the COVID-19 pandemic. Methods National surveillance data from 2016 to 2020 on the prevalence of HAIs measured by point prevalence surveys, and the incidence of surgical site infections (SSIs) and catheter-related bloodstream infections (CRBSIs) were used to compare rates between the pre-pandemic (2016–February 2020) and pandemic (March 2020–December 2020) period. Results The total HAI prevalence among hospitalised patients was higher during the pandemic period (7.4%) compared to pre-pandemic period (6.4%), mainly because of an increase in ventilator-associated pneumonia (VAP), gastro-intestinal infections (GIs) and central nervous system (CNS) infections. No differences in SSI rates were observed during the pandemic, except for a decrease after colorectal surgeries (6.3% (95%-CI 6.0–6.6%) pre-pandemic versus 4.4% (95%-CI 3.9–5.0%) pandemic). The observed CRBSI incidence in the pandemic period (4.0/1,000 CVC days (95%-CI 3.2–4.9)) was significantly higher than predicted based on pre-pandemic trends (1.4/1000 (95%-CI 1.0–2.1)), and was increased in both COVID-19 patients and non-COVID-19 patients at the intensive care unit (ICU). Conclusions Rates of CRBSIs, VAPs, GIs and CNS infections among hospitalised patients increased during the first year of the pandemic. Higher CRBSI rates were observed in both COVID-19 and non-COVID-19 ICU population. The full scope and influencing factors of the pandemic on HAIs needs to be studied in further detail.

An analysis of central venous catheter-related bloodstream infections in patients treated in a Swedish Covid-19 intensive care unit

“…Studies evaluating CRBSI o CLABSI incidence in COVID-19 patient with accepted endpoints are shown in Table 3 . 14 , 16 , 18 , 34 , 37 – 41 Our incidence is in the low range and indicates that our unit has been successful in taking care of CVCs in the C-ICU.…”

Impact of COVID-19 pandemic on healthcare-associated infections at intensive care units in South Korea: data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS)

“…The studies using national surveillance data conducted in ICUs of each country also showed different results. In a study conducted in the Netherlands, the incidence rates of VAP and CLABSI increased during the COVID-19 pandemic, 9 and a study conducted in France also reported an increase in VAP and BSI during the pandemic. 8 On the other hand, in a study conducted in ICUs in Germany, it was reported that the rate of CLABSI did not increase during the COVID-19 pandemic, and the rate of CAUTI decreased.…”

“…In previous reports, COVID-19 was reported to be associated with increased rates of healthcare-associated infections (HAIs). [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] These results could be attributed to the neglect of conventional infection control practices, such as monitoring of handwashing activities and contact precautions for multidrug-resistant organisms. On the other hand, the COVID-19 pandemic has led to the strengthening of personal protective equipment usage in healthcare facilities.…”

Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Surgical Site Infection in Patients with Inflammatory Bowel Disease—A Monocentric, Retrospective Cohort Study

“…A risk reduction in SSI during the COVID-19 pandemic was shown in two singlecenter studies in colorectal oncological surgery [27,29] and in one trial based on national surveillance data in colorectal surgery [30]. The number of patients was limited in the single-center studies, and elective surgery was conducted only in 72%.…”