Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Intern Med. 2024 May;39(3):513-523. doi: 10.3904/kjim.2023.508. Epub 2024 Apr 23.
BACKGROUND/AIMS: Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units.
This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic.
The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively).
The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.
背景/目的:自 2019 年冠状病毒病(COVID-19)爆发以来,医院已采取感染控制措施,以最大程度地减少设施内病毒的传播。本研究旨在调查 COVID-19 对血液科病房内发生的医源性感染(HAI)和常见呼吸道病毒(cRV)感染的影响。
这是一项回顾性研究,纳入了 2019 年至 2020 年期间在天主教血液病医院住院的所有患者。分析了感染万古霉素耐药肠球菌(VRE)、产碳青霉烯酶肠杆菌科(CPE)、艰难梭菌感染(CDI)和 cRV 的患者。采用发病率比值比(IRR)方法和中断时间序列分析比较大流行前后的发病率。
两个时期 CPE 和 VRE 的发病率没有差异。然而,COVID-19 大流行后 CDI 的发病率显著增加(IRR:1.41[P=0.002])。COVID-19 爆发后,cRV 感染的发病率下降了 76%(IRR:0.240[P<0.001])。COVID-19 期间,腺病毒、副流感病毒和鼻病毒感染的发病率显著下降(IRRs:0.087[P=0.003]、0.031[P<0.001]和 0.149[P<0.001])。
COVID-19 感染控制措施的实施降低了 cRV 感染的发病率。然而,CDI 的发病率显著增加,COVID-19 后血液病患者的 CPE 和 VRE 发病率保持不变。在未来的大流行中,应针对每种类型的 HAI(如 CDI 应严格洗手,足够的隔离能力)实施和维持感染控制措施,特别是在免疫功能低下的患者中。