Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX; Division of Infectious Diseases, Department of Medicine, The University of Texas Health Science Center at Houston, Houston, TX.
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
Am J Infect Control. 2023 Dec;51(12):1302-1308. doi: 10.1016/j.ajic.2023.08.019. Epub 2023 Oct 5.
Robust infection prevention and control (IPC) measures were deployed across health care institutions at the start of the COVID-19 pandemic, resulting in increased use of personal protective equipment, enhanced contact precautions, and an emphasis on hand hygiene. Here, we evaluate the effect of enhanced IPC practices on the occurrence of various hospital-associated infections (HAIs) in a comprehensive cancer center.
From September 2016 through March 2022, we calculated the incidence rates (IRs) of HAIs for C. difficile infection, multidrug-resistant organisms, respiratory viral infections (RVIs), and device-related infections. We analyzed the incidence rate ratios for all HAIs during the periods before the pandemic, during the pandemic, at the time of the surges, and in COVID-19-designated wards.
When comparing the prepandemic to the pandemic period, the IR across all MRDOs was similar. We observed a decrease in the IR of central line-associated bloodstream infections and a stable IR of catheter-associated urinary tract infections. A significant decrease was observed in the IR of C. difficile infection. The total IR of nosocomial RVIs decreased, as did for each respiratory virus. A similar IR of nosocomial RVIs between COVID-19 community surge versus nonsurge periods was observed except for SARS-CoV-2, RSV, and influenza. multidrug resistant organisms were 5 times more likely to occur on the COVID-19 wards compared with the non-COVID-19 wards.
Implementing strict IPC measures during the COVID-19 pandemic in a cancer hospital led to a significant decrease in many HAIs and a reduction in nosocomial RVIs.
在 COVID-19 大流行开始时，医疗机构全面部署了强有力的感染预防和控制（IPC）措施，导致个人防护设备的使用增加，接触预防措施得到加强，并且更加注重手部卫生。在这里，我们评估了强化 IPC 实践对综合癌症中心各种医院获得性感染（HAI）发生的影响。
从 2016 年 9 月到 2022 年 3 月，我们计算了艰难梭菌感染、多重耐药菌、呼吸道病毒感染（RVI）和器械相关感染的发病率（IR）。我们分析了大流行前、大流行期间、高峰期和 COVID-19 指定病房期间所有 HAI 的发病率比值比。
与大流行前相比，大流行期间所有多重耐药菌的发病率相似。我们观察到中心静脉相关血流感染的发病率下降，导管相关尿路感染的发病率稳定。艰难梭菌感染的发病率显著下降。医院获得性呼吸道病毒感染的总发病率下降，每种呼吸道病毒的发病率均下降。COVID-19 社区高峰与非高峰期间，医院获得性呼吸道病毒感染的发病率相似，除了 SARS-CoV-2、RSV 和流感。与非 COVID-19 病房相比，COVID-19 病房发生多重耐药菌的可能性高 5 倍。
在癌症医院实施 COVID-19 大流行期间的严格 IPC 措施导致许多 HAI 显著减少，医院获得性 RVI 减少。
