Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
Department of Medical Microbiology and Infection Prevention, University Medical Centre Utrecht, Utrecht, The Netherlands.
Antimicrob Resist Infect Control. 2023 Jan 5;12(1):2. doi: 10.1186/s13756-022-01201-z.
During the COVID-19 pandemic hospitals reorganized their resources and delivery of care, which may have affected the number of healthcare-associated infections (HAIs). We aimed to quantify changes in trends in the number of HAIs in Dutch hospitals during the COVID-19 pandemic.
National surveillance data from 2016 to 2020 on the prevalence of HAIs measured by point prevalence surveys, and the incidence of surgical site infections (SSIs) and catheter-related bloodstream infections (CRBSIs) were used to compare rates between the pre-pandemic (2016-February 2020) and pandemic (March 2020-December 2020) period.
The total HAI prevalence among hospitalised patients was higher during the pandemic period (7.4%) compared to pre-pandemic period (6.4%), mainly because of an increase in ventilator-associated pneumonia (VAP), gastro-intestinal infections (GIs) and central nervous system (CNS) infections. No differences in SSI rates were observed during the pandemic, except for a decrease after colorectal surgeries (6.3% (95%-CI 6.0-6.6%) pre-pandemic versus 4.4% (95%-CI 3.9-5.0%) pandemic). The observed CRBSI incidence in the pandemic period (4.0/1,000 CVC days (95%-CI 3.2-4.9)) was significantly higher than predicted based on pre-pandemic trends (1.4/1000 (95%-CI 1.0-2.1)), and was increased in both COVID-19 patients and non-COVID-19 patients at the intensive care unit (ICU).
Rates of CRBSIs, VAPs, GIs and CNS infections among hospitalised patients increased during the first year of the pandemic. Higher CRBSI rates were observed in both COVID-19 and non-COVID-19 ICU population. The full scope and influencing factors of the pandemic on HAIs needs to be studied in further detail.
在 COVID-19 大流行期间，医院重新组织了资源并调整了医疗服务，这可能影响了医疗保健相关感染（HAI）的数量。我们旨在量化 COVID-19 大流行期间荷兰医院 HAI 数量趋势的变化。
使用 2016 年至 2020 年期间通过点患病率调查测量的 HAI 患病率以及手术部位感染（SSI）和导管相关血流感染（CRBSI）的发病率的国家监测数据，比较大流行前（2016 年 2 月至 2020 年 3 月）和大流行期间（2020 年 3 月至 2020 年 12 月）的发病率。
住院患者的总 HAI 患病率在大流行期间（7.4%）高于大流行前（6.4%），主要是因为呼吸机相关性肺炎（VAP）、胃肠感染（GI）和中枢神经系统（CNS）感染增加。大流行期间未观察到 SSI 率的差异，但结直肠手术后有所下降（大流行前为 6.3%（95%CI 6.0-6.6%），大流行期间为 4.4%（95%CI 3.9-5.0%））。大流行期间观察到的 CRBSI 发病率（4.0/1000 中心静脉导管天（95%CI 3.2-4.9））明显高于根据大流行前趋势预测的发病率（1.4/1000（95%CI 1.0-2.1）），并且在 COVID-19 患者和非 COVID-19 患者的 ICU 中均有所增加。
大流行的第一年，住院患者的 CRBSI、VAP、GI 和 CNS 感染率有所增加。COVID-19 和非 COVID-19 ICU 人群的 CRBSI 率更高。需要更详细地研究大流行对 HAI 的全面影响和影响因素。
