Since the beginning of 2020, we have seen drastic changes in disease prevention and personal protective equipment (PPE) in efforts to prevent the spread of COVID-19. We have seen increased hand hygiene, increased PPE, decreased leisure travel, and decreased elective surgeries. It is unclear whether the rate of healthcare-associated infections (HAIs) has changed with these measures, or whether these changes are long-lasting. However, it is reasonable to expect a reduction in pathogen spread from increased diligence and public awareness in the short term.
Despite the lack of research on this topic, one study shows that recent changes in prevention protocols may actually increase the rates of other common HAIs. This study looked at the rate of change in central line-associated bloodstream infections (CLABSIs) before and after the onset of the pandemic (1). In short, the rates of CLABSIs significantly increased by 51 percent during the pandemic, after being controlled for the degree of device utilization. What is even more surprising to learn, is that hospitals with COVID-19 infected patients representing more than 10 percent of the admitted population, had a CLABSI infection ratio that was 2.38 times higher than hospitals with less than a five percent prevalence among admitted patients. This study may reflect a change in cleaning and prevention protocols that is less effective against the bacterial pathogens that existed before the pandemic.
While some preventative measures have been increased during the pandemic, it is possible that other precautions have been neglected. For example, an increase in PPE and hand hygiene may undermine the importance of environmental cleaning protocols on medical surfaces such as patient beds and treatment tables. Specifically, punctures and tears in hospital mattress covers may have been neglected due to the high demand for beds for COVID-19 patients. Patient mattresses are among the highest touch points in the healthcare environment and can harbour dangerous pathogens that come in direct contact with patients, but the cleanliness and integrity of patient beds may be put on low priority due to the overwhelmed healthcare system. Therefore, evaluating the current standing of environmental cleaning protocols could be a small step toward keeping patients safe throughout the pandemic, as HAIs remain rampant in the face of additional COVID-19 and PPE protocols.
- Fakih MG, Bufalino A, Sturm L, Huang RH, Ottenbacher A, Saake K, Winegar A, Fogel R, Cacchione J. Coronavirus disease 2019 (COVID-19) pandemic, central-line–associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): The urgent need to refocus on hardwiring prevention efforts. Infection Control & Hospital Epidemiology. 2021 Feb 19:1-6.
- IMAGE: AusMed. (2017, Nov 14). Central line-associated bloodstream Infections (CLABSI). Retrieved May 06, 2021, from https://www.ausmed.com/cpd/articles/central-line-associated-bloodstream-infections