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The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce.

Publication ,  Journal Article
Advani, SD; Sickbert-Bennett, E; Moehring, R; Cromer, A; Lokhnygina, Y; Dodds-Ashley, E; Kalu, IC; DiBiase, L; Weber, DJ; Anderson, DJ ...
Published in: Clin Infect Dis
February 8, 2023

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had a considerable impact on US healthcare systems, straining hospital resources, staff, and operations. However, a comprehensive assessment of the impact on healthcare-associated infections (HAIs) across different hospitals with varying level of infectious disease (ID) physician expertise, resources, and infrastructure is lacking. METHODS: This retrospective longitudinal multicenter cohort study included central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioides difficile infections (CDIs), and ventilator-associated events (VAEs) from 53 hospitals (academic and community) in Southeastern United States from 1 January 2018 to 31 March 2021. Segmented negative binomial regression generalized estimating equations models estimated changes in monthly incidence rates in the baseline (01/2018-02/2020) compared to the pandemic period (03/2020-03/2021, further divided into three pandemic phases). RESULTS: CLABSIs and VAEs increased by 24% and 34%, respectively, during the pandemic period. VAEs increased in all phases of the pandemic, while CLABSIs increased in later phases of the pandemic. CDI trend increased by 4.2% per month in the pandemic period. On stratifying the analysis by hospital characteristics, the impact of the pandemic on healthcare-associated infections was more significant in smaller sized and community hospitals. CAUTIs did not change significantly during the pandemic across all hospital types. CONCLUSIONS: CLABSIs, VAEs, and CDIs increased significantly during the pandemic, especially in smaller community hospitals, most of which lack ID physician expertise. Future efforts should focus on better understanding challenges faced by community hospitals, strengthening the infection prevention infrastructure, and expanding the ID workforce, particularly to community hospitals.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

February 8, 2023

Volume

76

Issue

3

Start / End Page

e34 / e41

Location

United States

Related Subject Headings

  • Urinary Tract Infections
  • Retrospective Studies
  • Pandemics
  • Microbiology
  • Humans
  • Hospitals, Community
  • Cross Infection
  • Communicable Diseases
  • Cohort Studies
  • Clostridium Infections
 

Citation

APA
Chicago
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Advani, S. D., Sickbert-Bennett, E., Moehring, R., Cromer, A., Lokhnygina, Y., Dodds-Ashley, E., … CDC Prevention Epicenters Program, . (2023). The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce. Clin Infect Dis, 76(3), e34–e41. https://doi.org/10.1093/cid/ciac684
Advani, Sonali D., Emily Sickbert-Bennett, Rebekah Moehring, Andrea Cromer, Yuliya Lokhnygina, Elizabeth Dodds-Ashley, Ibukunoluwa C. Kalu, et al. “The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce.Clin Infect Dis 76, no. 3 (February 8, 2023): e34–41. https://doi.org/10.1093/cid/ciac684.
Advani SD, Sickbert-Bennett E, Moehring R, Cromer A, Lokhnygina Y, Dodds-Ashley E, et al. The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce. Clin Infect Dis. 2023 Feb 8;76(3):e34–41.
Advani SD, Sickbert-Bennett E, Moehring R, Cromer A, Lokhnygina Y, Dodds-Ashley E, Kalu IC, DiBiase L, Weber DJ, Anderson DJ, CDC Prevention Epicenters Program. The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce. Clin Infect Dis. 2023 Feb 8;76(3):e34–e41.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

February 8, 2023

Volume

76

Issue

3

Start / End Page

e34 / e41

Location

United States

Related Subject Headings

  • Urinary Tract Infections
  • Retrospective Studies
  • Pandemics
  • Microbiology
  • Humans
  • Hospitals, Community
  • Cross Infection
  • Communicable Diseases
  • Cohort Studies
  • Clostridium Infections