Paediatric Infectious Diseases Unit, Rambam Health Care Campus, Haifa, Israel.
Infection Prevention and Control Unit, Rambam Health Care Campus, P.O. Box 9602, Haifa, 31096, Israel.
BMC Infect Dis. 2024 Nov 28;24(1):1364. doi: 10.1186/s12879-024-09240-0.
While effective preventive measures reduce hospital-acquired infections (HAIs) and the spread of multi-drug resistant organisms (MDROs), studies on the impact of the COVID-19 pandemic and its associated preventive measures remain inconclusive.
To assess the impact of COVID-19 on HAIs and MDROs and to compare it with the effect of seasonal influenza.
A retrospective cohort study analyzed prospectively collected data from a tertiary hospital in Haifa, northern Israel, from 2016 to 2021. It compared pre/during COVID-19 and influenza (Dec-Feb)/non-influenza (Mar-Nov) seasons. Studied parameters: hospital-acquired bloodstream infections (HA-BSI), MDROs, nosocomial Clostridioides difficile infections (CDI) per 10,000 hospital days (HD), central line-associated BSI (CLABSI) per 1000 catheter days (CD) and hand hygiene compliance (HHC).
During the COVID-19 period, rates of HAIs and MDROs decreased compared to the pre-COVID era for methicillin-resistant Staphylococcus aureus (MRSA) (4.2 vs. 6.9/10,000 HD; p < 0.001), carbapenem-resistant Acinetobacter baumani (CRAB) (2.2 vs. 3.1/10,000 HD; p = 0.02), and nosocomial CDI (3 vs. 4.6/10,000 HD; p < 0.001). However, there was a higher rate of carbapenem-resistant Enterobacteriaceae (CRE) (4.6 vs. 2.7/10,000 HD; p < 0.001) and HA-BSI (29.7 vs. 27.3/10,000 HD; p = 0.006) during the COVID-19 era. CLABSI rates showed no significant difference (2.3 vs. 2.7/1000 CD; p = 0.910). HHC rate remained at 70% in both eras (p = 0.151). No significant differences were observed in MDROs, CDI, HA-BSI, or CLABSI rates (p = 0.233, 0.675, 0.267, and 0.563, respectively) between influenza and non-influenza seasons.
In the COVID-19 era, HAIs and MDROs rates significantly declined, while CRE rates increased, possibly due to a national trend in Israel since 2016. Steady HHC rates suggest additional factors like enhanced environmental cleaning, personal protective equipment usage, and increased infection prevention awareness contributed to this decline. Influenza had no noticeable impact, likely due to healthcare workers' varying perceptions and the brevity of the influenza season, making it challenging to assess impact.
虽然有效的预防措施可以降低医院获得性感染（HAIs）和多重耐药菌（MDROs）的传播，但关于 COVID-19 大流行及其相关预防措施的影响的研究仍尚无定论。
评估 COVID-19 对 HAIs 和 MDROs 的影响，并将其与季节性流感的影响进行比较。
对以色列北部海法市一家三级医院的前瞻性收集数据进行回顾性队列研究，时间为 2016 年至 2021 年。研究比较了 COVID-19 之前和期间与流感（12 月至 2 月）/非流感（3 月至 11 月）季节。研究参数：医院获得性血流感染（HA-BSI）、MDROs、每 10000 个住院日（HD）的医院获得性艰难梭菌感染（CDI）（4.6/10000 HD；p<0.001）、每 1000 个导管日（CD）的中心静脉相关 BSI（CLABSI）（2.3/1000 CD；p=0.910）和手卫生依从性（HHC）（70%，p=0.151）。
在 COVID-19 期间，与 COVID-19 前相比，耐甲氧西林金黄色葡萄球菌（MRSA）（4.2/10000 HD；p<0.001）、耐碳青霉烯鲍曼不动杆菌（CRAB）（2.2/10000 HD；p=0.02）和医院获得性 CDI（3/10000 HD；p<0.001）的 HAIs 和 MDROs 发生率降低。然而，在 COVID-19 期间，耐碳青霉烯肠杆菌科（CRE）（4.6/10000 HD；p<0.001）和 HA-BSI（29.7/10000 HD；p=0.006）的发生率更高。CLABSI 率无显著差异（2.3/1000 CD；p=0.910）。在两个时期，HHC 率均保持在 70%（p=0.151）。MDROs、CDI、HA-BSI 或 CLABSI 率在流感和非流感季节之间无显著差异（p=0.233、0.675、0.267 和 0.563）。
在 COVID-19 期间，HAIs 和 MDROs 发生率显著下降，而 CRE 发生率上升，这可能是由于以色列自 2016 年以来的全国趋势。稳定的 HHC 率表明，其他因素，如增强的环境清洁、个人防护设备的使用以及提高的感染预防意识，也有助于这一下降。流感没有明显的影响，这可能是由于医护人员对流感的不同看法和流感季节的短暂性，使得评估其影响变得困难。
