COVID-19 mitigation measures tied to fewer infant bacterial infections
A study of 97 hospitals in the United States and Canada found that the incidence of urinary tract infection (UTI) and invasive bacterial infection (IBI) in infants with fever fell to pre-pandemic levels by early 2022, researchers reported yesterday in Pediatrics.
The multicenter cross-sectional study, conducted from November 2020 through March 2022, included full-term, previously healthy, well-appearing infants 8 to 60 days old who visited an emergency department or were hospitalized with a temperature of 38°C (100.4°F) or higher. Because single-center studies have suggested a higher proportion of infants with UTI and IBI in the months following the beginning of the COVID-19 pandemic, the researchers wanted to examine UTI and IBI prevalence in a larger, more geographically diverse population over the course of the pandemic. They also aimed to determine if there was any association between COVID-19 prevalence and the odds of an infant having UTI and IBI.
Of the 9,112 infants included in the study, 603 (6.6%) had UTI, 163 (1.8%) had bacteremia without meningitis, and 43 (0.5%) had bacterial meningitis. UTI prevalence decreased from 11.2% in November 2020 to 3.0% in January 2022. IBI prevalence was highest in February 2021 (6.1%) and decreased to 0.4% in January 2022.
There was a significant downward monthly trend for odds of UTI (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.91 to 0.94) and IBI (OR, 0.90; 95% CI, 0.87 to 0.93). For every 5% increase in COVID-19 prevalence in the month of presentation, the odds of an infant having UTI (OR, 0.97; 95% CI, 0.96 to 0.98) or bacteremia without meningitis decreased (OR, 0.94; 95% CI, 0.88 to 0.99).
“The prevalence estimates from our study demonstrate that the risk of UTI, bacteremia, and bacterial meningitis among febrile infants is higher in time periods when respiratory viral infections are likely of low prevalence, potentially because of pandemic mitigation measures, but then return to baseline risk, or lower, when these measures end,” the study authors wrote. “With the potential for future pandemics, understanding the impact of mitigation measures upon bacterial infection prevalence in febrile infants is a key component to informed decision-making between clinicians and parents.”
Nov 10 Pediatrics study
CDC: Healthcare-associated infections continued to climb in 2021
A new report from the Centers for Disease Control and Prevention (CDC) shows that healthcare-associated infections (HAIs) in US hospitals remain elevated above pre–COVID-19 pandemic levels.
Findings from the review of quarterly 2021 National Healthcare Safety Network data show continued increases in the quarterly standardized infections ratios (SIRs) for central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia compared with 2019. The report analyzed data from acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, and long-term acute care hospitals.
Overall, CLABSIs rose by 7% from 2020 to 2021, CAUTIs increased 5%, VAEs climbed by 12%, and hospital-onset MRSA bacteremia rose by 14%. The largest increases were seen in intensive care units. Among other HAIs, surgical-site infections saw no significant changes from 2020 to 2021, and hospital-onset Clostridioides difficile infections fell by 3%.
While the increases in CLABSIs, CAUTIs, VAEs, and MRSA bacteremia are notably smaller than those observed in 2020, when hospitals across the country were overwhelmed with COVID-19 patients, they reflect the continued strain that the pandemic has placed on US hospitals, the CDC said.
“In 2021, the nation and the world continued to experience unprecedented challenges due to the COVID-19 pandemic, which impacted surveillance for and incidence of HAIs,” the report authors wrote. “Compared to pre-pandemic years, hospitals across the nation experienced higher than usual hospitalizations and shortages in healthcare personnel and equipment, which may have resulted in deterioration in multiple patient safety metrics since the beginning of the pandemic.”
On a positive note, the report also shows that, compared with the 2015 national SIRs, 49 states performed better on at least two infections, 33 performed better on three infection types, and 20 performed better on four infection types.
According to the CDC, approximately 1 in 31 US hospital patients, and 1 in 43 nursing home residents, acquires at least one infection linked to their healthcare each day.
Nov 4 CDC HAI progress report
