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2019冠状病毒病(COVID-19)大流行期间血液系统恶性肿瘤和干细胞移植患者的医疗相关感染率评估

Evaluation of healthcare-associated infection rates in patients with hematologic malignancies and stem cell transplantation during the coronavirus disease 2019 (COVID-19) pandemic.

作者信息

Bobbitt Laura J, Satyanarayana Gowri, Van Metre Baum Laura, Nebhan Caroline A, Kassim Adetola A, Gatwood Katie S

机构信息

Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee.

Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

出版信息

Antimicrob Steward Healthc Epidemiol. 2022 Jan 17;2(1):e11. doi: 10.1017/ash.2021.237. eCollection 2022.

Abstract

OBJECTIVE

To evaluate whether rates of healthcare-associated infections (HAIs) changed during the coronavirus disease 2019 (COVID-19) pandemic in malignant hematology and stem cell transplant patients.

DESIGN

A retrospective, cohort study.

PATIENTS

The study included malignant hematology and stem cell transplant patients admitted between March 1, 2019, through July 31, 2019, and March 1, 2020, through July 31, 2020.

METHODS

Rates of catheter-associated urinary tract infections (CAUTIs), central-line-associated bloodstream infections (CLABSIs), central-line-associated mucosal barrier injury infections (CLAMBIs), and infections (CDIs) during the pandemic were compared to those in a control cohort. Secondary outcomes included the rate of non-COVID-19 respiratory viruses.

RESULTS

The rate of CAUTIs per 1,000 hospital days was 0.435 before the pandemic and 0.532 during the pandemic (incidence rate ratio [IRR], 1.224; 95% confidence interval [CI], 0.0314-47.72; = .899). The rate of CLABSIs was 0.435 before the pandemic and 1.064 during the pandemic (IRR, 2.447; 95% CI, 0.186-72.18; = .516). The rate of CLAMBIs was 2.61 before the pandemic and 1.064 during the pandemic (IRR 0.408, 95% CI 0.057-1.927; = .284). The rate of CDIs was 2.61 before the pandemic and 1.579 during the pandemic (IRR, 0.612; 95% CI, 0.125-2.457; = .512). Non-COVID-19 respiratory virus cases decreased significantly from 12 (30.8%) to 2 cases (8.3%) ( = 0.014).

CONCLUSIONS

There was no significant difference in HAIs among inpatient malignant hematology and stem cell transplant patients during the COVID-19 pandemic compared to those of a control cohort. Rates of infection were low among both cohorts. Rates of community-acquired respiratory viruses decreased significantly during the pandemic among this population.

摘要

目的

评估2019冠状病毒病(COVID-19)大流行期间恶性血液病和干细胞移植患者的医疗相关感染(HAIs)发生率是否发生变化。

设计

一项回顾性队列研究。

患者

该研究纳入了2019年3月1日至2019年7月31日以及2020年3月1日至2020年7月31日期间收治的恶性血液病和干细胞移植患者。

方法

将大流行期间导尿管相关尿路感染(CAUTIs)、中心静脉导管相关血流感染(CLABSIs)、中心静脉导管相关黏膜屏障损伤感染(CLAMBIs)以及艰难梭菌感染(CDIs)的发生率与对照组进行比较。次要结局包括非COVID-19呼吸道病毒的发生率。

结果

大流行前每1000个住院日的CAUTIs发生率为0.435,大流行期间为0.532(发病率比[IRR],1.224;95%置信区间[CI],0.0314 - 47.72;P = 0.899)。CLABSIs发生率在大流行前为0.435,大流行期间为1.064(IRR,2.447;95% CI,0.186 - 72.18;P = 0.516)。CLAMBIs发生率在大流行前为2.61,大流行期间为1.064(IRR 0.408,95% CI 0.057 - 1.927;P = 0.284)。CDIs发生率在大流行前为2.61,大流行期间为1.579(IRR,0.612;95% CI,0.125 - 2.457;P = 0.512)。非COVID-19呼吸道病毒病例从12例(30.8%)显著减少至2例(8.3%)(P = 0.014)。

结论

与对照组相比,COVID-19大流行期间住院恶性血液病和干细胞移植患者的HAIs无显著差异。两个队列中的感染发生率均较低。该人群中社区获得性呼吸道病毒的发生率在大流行期间显著下降。

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