Bloodstream Infection Risk, Incidence, and Deaths for Hospitalized Patients during Coronavirus Disease Pandemic

Abstract

Hospital-acquired infections are emerging major concurrent conditions during the coronavirus disease (COVID-19) pandemic. We conducted a retrospective review of hospitalizations during March‒October 2020 of adults tested by reverse transcription PCR for severe acute respiratory syndrome coronavirus 2. We evaluated associations of COVID-19 diagnosis with risk for laboratory-confirmed bloodstream infections (LCBIs, primary outcome), time to LCBI, and risk for death by using logistic and competing risks regression with adjustment for relevant covariates. A total of 10,848 patients were included in the analysis: 918 (8.5%) were given a diagnosis of COVID-19, and 232 (2.1%) had LCBIs during their hospitalization. Of these patients, 58 (25%) were classified as having central line‒associated bloodstream infections. After adjusting for covariates, COVID-19‒positive status was associated with higher risk for LCBI and death. Reinforcement of infection control practices should be implemented in COVID-19 wards, and review of superiority and inferiority ranking methods by National Healthcare Safety Network criteria might be needed.

Keywords: COVID-19; SARS-CoV-2; bloodstream infection risk; coronavirus disease; coronaviruses; deaths; hospitalized patients; incidence; infection control; pandemic; prone positioning; respiratory infections; severe acute respiratory coronavirus 2; viruses; zoonoses.

Figure

Organisms responsible for laboratory-confirmed bloodstream infections during COVID-19 pandemic, Miami, Florida, USA, March 25‒October 27, 2020. A) COVID-19‒negative patients (n = 168). B) COVID-19‒positive patients (n = 64). COVID-19, coronavirus disease; MDA, organisms isolated during admission (defined as >2 organisms isolated from the bloodstream >48 hours apart during admission); MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive S. aureus; MSS, multiple organisms isolated during bloodstream infection episode (defined >2 organisms isolated from the bloodstream within a 48-hour period from the index isolate).