Surge in Ventilator-Associated Pneumonias and Bloodstream Infections in An Academic Referral Center Converted to Treat COVID-19 Patients



Document title: Surge in Ventilator-Associated Pneumonias and Bloodstream Infections in An Academic Referral Center Converted to Treat COVID-19 Patients
Journal: Revista de investigación clínica
Database: PERIÓDICA
System number: 000453037
ISSN: 0034-8376
Authors: 1
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Institutions: 1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Epidemiología Hospitalaria, Ciudad de México. México
2Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Enfermedades Infecciosas, Ciudad de México. México
3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Urgencias, Ciudad de México. México
4Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Unidad de Cuidados Intensivos, Ciudad de México. México
5Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Dirección de Medicina, Ciudad de México. México
Year:
Season: Jul-Ago
Volumen: 73
Number: 4
Pages: 210-215
Country: México
Language: Inglés
Document type: Nota breve o noticia
Approach: Aplicado, descriptivo
English abstract Background: Healthcare-associated infections (HAIs) are important adverse events that must be prevented. Objective: The objective of the study was to report and study possible changes in HAI rates as well as their causes after the COVID-19 hospital surge capacity response (HSCR) in an academic referral center. Methods: This was a before-after observational study. The Infection Prevention and Control (IPC) program (prospective surveillance, prevention bundles, antibiotic stewardship, continuing education, and feedback) was transiently disrupted after the start of HSCR (March 2020). HAI rates were compared before (January 2019-February 2020) and after (April-July 2020) HSCR, and plausible predisposing factors in affected patients were compared. Results: An increase in the HAI rate from 6.2 to 11.8 cases/1000 patient-days was noted between periods due to increases in ventilator-associated pneumonia and bloodstream infection (BSI) rates. More critically ill patients were admitted during HSCR, and use of invasive devices increased. Prone positioning and infusion of muscle relaxants became commonplace. The nurse-to-patient ratio in the intensive care unit decreased, and 4 h shifts were introduced to avoid fatigue. The BSI rate decreased after the IPC program with additional measures was reintroduced in May 2020. Conclusions: The strain on the workforce and modifications to the IPC program very possibly underlay the findings. IPC programs continue to be essential during the pandemic
Disciplines: Medicina
Keyword: Hospitales,
Neumología,
Infección hospitalaria,
Neumonia asociada al ventilador,
COVID-19
Keyword: Hospitals,
Pneumology,
Nosocomial infections,
Ventilator associated pneumonia,
COVID-19
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