Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infections in hospitalized patients

Trevor S. Farthing, Ashlan Jolley, Katelin B. Nickel, Cherie Hill, Dustin Stwalley, Kimberly A. Reske, Jennie H. Kwon, Margaret A. Olsen, Jason P. Burnham, Erik R. Dubberke, Cristina Lanzas

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: We compared the individual-level risk of hospital-onset infections with multidrug-resistant organisms (MDROs) in hospitalized patients prior to and during the coronavirus disease 2019 (COVID-19) pandemic. We also quantified the effects of COVID-19 diagnoses and intrahospital COVID-19 burden on subsequent MDRO infection risk. Design: Multicenter, retrospective, cohort study. Setting: Patient admission and clinical data were collected from 4 hospitals in the St. Louis area. Patients: Data were collected for patients admitted between January 2017 and August 2020, discharged no later than September 2020, and hospitalized ≥48 hours. Methods: Mixed-effects logistic regression models were fit to the data to estimate patients' individual-level risk of infection with MDRO pathogens of interest during hospitalization. Adjusted odds ratios were derived from regression models to quantify the effects of the COVID-19 period, COVID-19 diagnosis, and hospital-level COVID-19 burden on individual-level hospital-onset MDRO infection probabilities. Results: We calculated adjusted odds ratios for COVID-19-era hospital-onset Acinetobacter spp., P. aeruginosa and Enterobacteriaceae spp infections. Probabilities increased 2.64 (95% confidence interval [CI], 1.22-5.73) times, 1.44 (95% CI, 1.03-2.02) times, and 1.25 (95% CI, 1.00-1.58) times relative to the prepandemic period, respectively. COVID-19 patients were 4.18 (95% CI, 1.98-8.81) times more likely to acquire hospital-onset MDRO S. aureus infections. Conclusions: Our results support the growing body of evidence indicating that the COVID-19 pandemic has increased hospital-onset MDRO infections.

Original languageEnglish
Pages (from-to)1966-1971
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume44
Issue number12
DOIs
StatePublished - Dec 29 2023

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