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)

Lee, Yu‐Mi; Kim, Dong Yoon; Kim, Eun Jin; Park, Ki Ho; Lee, Mi Suk

doi:10.1016/j.jhin.2023.05.010

Cited by 6 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…, 2022 [ 14 ] COVID-19 CLABSI, CAUTI, ventilator-associated lower respiratory infections (VALRTI) and bloodstream infections associated with the use of Extracorporeal-Life-Support-Systems (ECLSABSI) Germany Retrospective data analysis National Reference Center for Surveillance of Nosocomial Infections (921 German ICUs) No increase was shown for CLABSI No difference The lack of HAI increase in German ICUs may be due to the lower overall incidence of COVID-19 in Germany in 2020 compared with US or the very high availability of ICU beds Halverson et al. , 2022 [ 20 ] COVID-19 HAIs, including CLABSI, CAUTI, CDI and MRSA infections USA Retrospective cohort study 2 hospitals in Illinois, 159 bed community and 894 bed academic hospital Significant increase in CLABSI per 1000 patient days and 1000 device days during the pandemic Increase Lee [ 30 ] COVID-19 BSI, CLABSI, CAUTI and VAP South Korea Retrospective data analysis Data from the Korean National Healthcare-Associated Infections Surveillance System The rates of BSI and CLABSI 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 Increase Meynaar et al. , 2022 [ 29 ] COVID-19 CLABSI rates and use of dexamethasone and interleukin antagonists Netherlands Retrospective data analysis Intensive Care Unit at the Haga Teaching Hospital (The Hague) The risk of CLABSI was significantly increased among COVID-19 patients treated with dexamethasone Increase Mitra et al.…”

Section: Resultsmentioning

confidence: 99%

“…The significant increase in CLABSI rates is not limited to the US, but it has also been described at global level. Higher incidences of line infections among COVID-19 patients were observed in Brazil [ 28 ], the Netherlands [ 29 ], South Korea [ 30 ] and some LMICs [ 31 ]. The data from 21 Brazilian ICUs showed a significant increase in the median CLABSI incidence during the pandemic.…”

Section: Resultsmentioning

confidence: 99%

“…In South Korea [ 30 ], the rates of BSI and CLABSI significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates decreased in small-to-medium-sized hospitals. The reasons for this difference are not apparent and, on further segmented regression analysis, the rate of CLABSI demonstrated an increasing trend during the COVID-19 pandemic even in small-to-medium-sized hospitals, but without reaching a statistical significance.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review

Satta,

Rawson,

Moore

2023

Infection Prevention in Practice

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review

Satta,

Rawson,

Moore

2023

Infection Prevention in Practice

View full text Add to dashboard Cite

“…As presented in Table 1 , 24 studies providing estimates of the association between COVID-19 status and ICU-acquired infection/colonization with resistant bacteria fulfilled our inclusion criteria [ 2 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Section: Epidemiologymentioning

confidence: 99%

ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review

Gaudet,

Kreitmann,

Nseir

2023

Antibiotics

View full text Add to dashboard Cite

A large proportion of ICU-acquired infections are related to multidrug-resistant bacteria (MDR). Infections caused by these bacteria are associated with increased mortality, and prolonged duration of mechanical ventilation and ICU stay. The aim of this narrative review is to report on the association between COVID-19 and ICU-acquired colonization or infection related to MDR bacteria. Although a huge amount of literature is available on COVID-19 and MDR bacteria, only a few clinical trials have properly evaluated the association between them using a non-COVID-19 control group and accurate design and statistical methods. The results of these studies suggest that COVID-19 patients are at a similar risk of ICU-acquired MDR colonization compared to non-COVID-19 controls. However, a higher risk of ICU-acquired infection related to MDR bacteria has been reported in several studies, mainly ventilator-associated pneumonia and bloodstream infection. Several potential explanations could be provided for the high incidence of ICU-acquired infections related to MDR. Immunomodulatory treatments, such as corticosteroids, JAK2 inhibitors, and IL-6 receptor antagonist, might play a role in the pathogenesis of these infections. Additionally, a longer stay in the ICU was reported in COVID-19 patients, resulting in higher exposure to well-known risk factors for ICU-acquired MDR infections, such as invasive procedures and antimicrobial treatment. Another possible explanation is the surge during successive COVID-19 waves, with excessive workload and low compliance with preventive measures. Further studies should evaluate the evolution of the incidence of ICU-acquired infections related to MDR bacteria, given the change in COVID-19 patient profiles. A better understanding of the immune status of critically ill COVID-19 patients is required to move to personalized treatment and reduce the risk of ICU-acquired infections. The role of specific preventive measures, such as targeted immunomodulation, should be investigated.

show abstract

“…However, existing multicenter studies are generally limited to data from select hospital systems ( 7 – 12 ) and intensive care units (ICUs) ( 13 – 16 ), with varying outcomes perhaps relating to institution-specific factors during the pandemic. Larger nation-wide studies, on the other hand, have generally been limited to hospital-reported nosocomial infections in administrative surveillance data, which may be subject to reporting errors, particularly during the pandemic onset and its associated institutional pressures ( 15 – 19 ). Furthermore, while the pandemic would be expected to have had differential effects on community-acquired infections compared to those acquired in hospitals and other institutions, only a few studies have stratified their analysis accordingly.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

Driedger,

Daneman,

Brown

et al. 2023

Microbiol Spectr

View full text Add to dashboard Cite

The COVID-19 pandemic has likely influenced the epidemiology of bacterial infections through wide-ranging changes to clinical practices and infection control and prevention interventions. We sought to determine how the detection and incidence of bloodstream infections (BSIs) have been influenced by the pandemic. We performed a retrospective analysis of blood culture data in the province of Ontario, Canada, from 1 January 2017 to 31 December 2020. Outcomes included a weekly incidence of blood culture tests, BSIs, and contaminant results. Results were stratified by hospital, community, and long-term care (LTC) settings. An interrupted time series analysis using segmented regression models was used to determine changes in outcome incidence/prevalence during the pre- and peri-pandemic periods. Of the 14,083,853 individuals included, 129,329 (0.92%) developed a bloodstream infection. The blood culture ordering rate increased during the pandemic in the hospital setting only [Incidence rate ratio (IRR) 1.09, 95% confidence interval (CI) 1.01–1.19]. There was a decline in the incidence of community-acquired (IRR 0.95, 95% CI 0.91–0.99) and LTC-acquired (IRR 0.85, 95% CI 0.76–0.94) BSIs. Hospital-acquired BSIs were unchanged. The proportion of blood culture contaminants increased in the community (7% increase, P < 0.01) and LTC settings (14% increase, P < 0.05). There was decreased incidence of community-acquired Streptococcus pneumoniae (IRR 0.43, 95% CI 0.33–0.57) and Staphylococcus aureus (IRR 0.91, 95% CI 0.84–0.99) bacteremia. Pandemic-related changes in the performance of blood cultures and the epidemiology of BSIs have implications for current and future pandemic antimicrobial use, healthcare resource allocation, and hospital and laboratory policies. IMPORTANCE Bacterial infections are a significant cause of morbidity and mortality worldwide. In the wake of the COVID-19 pandemic, previous studies have demonstrated pandemic-related shifts in the epidemiology of bacterial bloodstream infections (BSIs) in the general population and in specific hospital systems. Our study uses a large, comprehensive data set stratified by setting [community, long-term care (LTC), and hospital] to uniquely demonstrate how the effect of the COVID-19 pandemic on BSIs and testing practices varies by healthcare setting. We showed that, while the number of false-positive blood culture results generally increased during the pandemic, this effect did not apply to hospitalized patients. We also found that many infections were likely under-recognized in patients in the community and in LTC, demonstrating the importance of maintaining healthcare for these groups during crises. Last, we found a decrease in infections caused by certain pathogens in the community, suggesting some secondary benefits of pandemic-related public health measures.

show abstract

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)

Cited by 6 publications

References 15 publications

Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review

Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review

ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

Contact Info

Product

Resources

About