Source avec lien : Clinical Infectious Diseases, (En ligne). 10.1093/cid/ciac684
La pandémie de COVID-19 a eu un impact considérable sur les systèmes de santé américains, mettant à rude épreuve les ressources, le personnel et les opérations des hôpitaux. Cependant, il n’existe pas d’évaluation complète de l’impact sur les infections associées aux soins (IAS) dans différents hôpitaux dont le niveau d’expertise des médecins spécialisés en maladies infectieuses, les ressources et les infrastructures varient. Cette étude de cohorte rétrospective longitudinale multicentrique a porté sur les infections sanguines associées aux cathéters centraux (CLABSI), les infections urinaires associées aux cathéters (CAUTI), les infections à C. difficile (CDI) et les événements associés aux ventilateurs (VAE) de 53 hôpitaux (universitaires et communautaires) du sud-est des États-Unis du 1er janvier 2018 au 31 mars 2021.
The 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.This retrospective longitudinal multi-center cohort study included central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), C. difficile infections (CDIs), and ventilator-associated events (VAEs) from 53 hospitals (academic and community) in Southeastern United States from January 1, 2018 to March 31, 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).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.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 infection prevention infrastructure, and expanding the ID workforce, particularly to community hospitals.