CDC: 'Perfect storm' fueled a spike in healthcare-associated infections in 2020

Hospital COVID Healthcare workers during an intubation procedure to a COVID patient
Thanks to the COVID-19 pandemic, the Centers for Disease Control and Prevention said quarterly central line-associated bloodstream infections were up by as much as 47% year over year while quarterly ventilator-associated events jumped as high as 44.8%. (Getty/Tempura)

Reports of several types of healthcare-associated infections skyrocketed in 2020 as hospitals were contending with the COVID-19 pandemic, according to new national surveillance data.

Per a Centers for Disease Control and Prevention (CDC) analysis published Thursday in Infection Control & Hospital Epidemiology, quarterly incidence of healthcare-associated infections (HAIs) rose as much as 47% year over year with central line-associated bloodstream infections leading the way.

These specific infections are tied to catheters inserted directly into large blood vessels over long periods, which were in heavier use while treating COVID-19 patients.

There also were increases in ventilator-associated events (VAEs), which saw a quarterly year-over-year increase as high as 44.8%; quarterly methicillin-resistant Staphylococcus aureus, which rose as much as 33.8% year over year; and quarterly catheter-associated urinary tract infections, which gained as much as 18.8% year over year.

The increases across these areas similarly reflected increased burdens tied to the COVID-19 pandemic, including challenges involving staffing and supply. Of note regarding VAEs, the analysis also found a large increase in standardized infection rates that would indicate the higher rates were not just a product of more devices being used.

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“The new data … are quite troubling and must serve as a call to action,” Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology (APIC), said in a statement. “As a nation, we must take significant efforts to bolster our infection prevention and control programs throughout the healthcare continuum.”

Two other types of HAIs, surgical-site infections and Clostridioides difficile, were found to have remained steady or declined during 2020. Here, the researchers pointed to the reduced number of elective surgeries being performed and an overall increased focus on infection control as likely explanations for those trends.

The CDC’s researchers conducted their analysis using data reported to the National Healthcare Safety Network, an HAI surveillance system used by most U.S. hospitals to fulfill their infection reporting requirements.

The researchers, Pettis and Arjun Srinivasan, M.D., the CDC’s associate director of Healthcare Associated Infection Prevention Programs, each noted that increases in the four HAIs reverse a steady decline in these infections nationwide.

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The pandemic, Srinivasan said, served as a “perfect storm” to fuel their transmission.

“Prior to the pandemic, public health—in partnership with hospitals—successfully drove down these infections for several years across U.S. hospitals,” Srinivasan said in a statement. “Strengthening infection prevention and control capacities works. This information emphasizes the importance of building stronger, deeper and broader infection control resources throughout healthcare that will not only improve our ability to protect patients in future pandemics but will also improve patient care every day.”

Pettis’ statement similarly suggested that healthcare facilities take a hard look at their existing infection prevention programs but additionally petitioned government agencies for support.

“APIC also calls on federal and state governments to provide funding to help support healthcare facilities across the continuum of care to ensure that there is adequate surge capacity so that infection prevention and control measures will endure when stressed by future pandemics and disease outbreaks,” she said.

Government oversight of infection control practices has been lacking throughout the pandemic.

According to a June report from the Office of Inspector General, CMS was only able to request, not require, that its private accreditation organization partners perform their special targeted infection control surveys, leading to just a fraction of the roughly 4,200 hospitals they oversee being monitored during 2020.