A Qatar-based study has highlighted the need for more strategies in infection control to avoid healthcare-associated infections (HAI), especially the device-associated ones.
According to an article published on Qscience.com, the study was conducted at Cuban Hospital of Hamad Medical Corporation (HMC) on 155 patients with HAIs reported from 130 (85.5%) during the Covid-19 pandemic.
An increase in the incidence of HAIs, particularly device-associated infections (DAIs), was reported worldwide during the pandemic. The study was aimed to estimate the incidence of HAIs in an intensive care unit during a 10-year period and compare HAI incidence during the pre-Covid-19 and Covid-19 periods.
The study highlights that HAIs in critical patients affect the quality and safety of patient care and increase patient morbidity and mortality. Moreover, HAI decreases efficiency in the healthcare system due to prolonged hospital stays, antimicrobial use and other cost-related issues.
Highlighting the findings of various reports, the study notes that before the pandemic, DAI prevention and control showed progress in reducing the incidence of DAIs and other adverse outcomes. The Covid-19 pandemic has significantly disrupted global healthcare systems. Infection prevention and control programmes have been seriously affected with increased HAI incidence and compromised staff safety and healthcare efficiency.
Originally a 75-bed public hospital, the Cuban Hospital expanded to 385 beds, after becoming part of HMC. The facility’s infection control programme is guided by the corporate infection control programme. Data from infection surveillance suggest an increase in the incidence of HAIs in the pandemic compared to the pre-pandemic period, mostly in critically ill patients.
A retrospective, observational study of HAIs in the medical–surgical ICU at the Cuban Hospital was conducted. DAIs included central line-associated bloodstream infections, catheter-associated urinary tract infections and ventilator-associated pneumonia. Data included the annual incidence of HAIs, etiology, and antimicrobial resistance, using definitions provided by the Centres for Disease Control and Prevention, except for other respiratory tract infections.
The frequencies of DAIs and non-DAIs were higher during the Covid-19 period, except for Clostridium difficile infections. Species under Enterobacter, Klebsiella, and Pseudomonas dominated in both periods, and higher frequencies of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophoma maltophila were noted during Covid-19 period. Device utilisation ratio increased to 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilisation ratio was observed.
The most frequently reported infection was other respiratory tract infections which were not classified as ventilator-associated pneumonia. In patients with coronavirus infection, there were two confirmed cases of bloodstream infection related to peripheral venous lines, four cases with decubitus ulcer infection, five cases of skin infection associated with tracheostomy, and one case of symptomatic urinary tract infection.
The study also found out that DAI incidence was higher during the pandemic, with risks for central line-associated bloodstream infections, catheter-associated urinary tract infections and ventilator-associated pneumonia increased by 2.79%, 15.31% and 3.25% respectively.
The study concluded that incidence of DAIs increased during the pandemic period, with limited evidence of antimicrobial resistance. It suggests that the infection control programme should evaluate strategies to minimise the impact of the pandemic on HAIs.
Cuban hospital
