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. 2023 Dec 14;3(1):e235.
doi: 10.1017/ash.2023.505. eCollection 2023.

Impact of intensified prevention measures on the rate of hospital-acquired bloodstream infections among mechanically ventilated COVID-19 patients

Shimrit Lampl  1 , Yael Cohen  1 , Yasmin Maor  1   2 , Debby Ben-David  1   2
Affiliations

Impact of intensified prevention measures on the rate of hospital-acquired bloodstream infections among mechanically ventilated COVID-19 patients

Shimrit Lampl et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Background: The COVID-19 pandemic was associated with increased rates of hospital-acquired infections. During the early months of the pandemic, we observed high rates of hospital-acquired bloodstream infections (HA-BSIs) among COVID-19 patients, prompting the implementation of intensified prevention measures.

Objectives: To assess the prevalence of HA-BSI among mechanically ventilated COVID-19 patients, identify risk factors, and evaluate the effect of prevention measures.

Methods: We conducted a retrospective matched case-control study in adult medical step-up units between March 1, 2020, and March 31, 2021. We matched mechanically ventilated COVID-19 patients with ventilated non-COVID-19 patients based on age group and length of stay before ventilation. In response to the high rates of HA-BSI among COVID-19 patients, a comprehensive infection control intervention was implemented.

Results: A total of 136 COVID-19 patients were matched with 136 non-COVID-19 patients. No significant differences were observed in pre-hospitalization characteristics. The central venous catheter utilization ratio was higher in COVID-19 patients (83.6%) versus 35.6% in the control group (p < 0.001). During pre-intervention, 35.2% (32/91) of COVID-19 patients developed HA-BSI, compared to 17.8% (13/73) in the control group (p < 0.001). Following the intervention, no significant difference was observed between the groups (17.8% (8/45) versus 15.9% (10 /63), p = 0.79). In a multivariate analysis, HA-BSI was associated with low body mass index (OR 0.9 (95% CI 0.9-1.0), p = 0.015)) and presence of temporary dialysis catheter (OR 2.7 (95% CI 1.0-7.3), p = 0.05)).

Conclusions: Mechanically ventilated COVID-19 patients were at higher risk for developing HA-BSI compared to non-COVID-19 patients. Intensified prevention measures were associated with decreased rates of HA-BSI.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article.

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