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Healthcare-associated infections in Veterans Affairs acute-care and long-term healthcare facilities during the coronavirus disease 2019 (COVID-19) pandemic

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  05 April 2022

Martin E. Evans Open the ORCID record for Martin E. Evans [Opens in a new window] ,
Loretta A. Simbartl ,
Stephen M. Kralovic ,
Marla Clifton ,
Kathleen DeRoos ,
Brian P. McCauley Open the ORCID record for Brian P. McCauley [Opens in a new window] ,
Natalie Gauldin ,
Linda K. Flarida ,
Shantini D. Gamage Open the ORCID record for Shantini D. Gamage [Opens in a new window]  and
Makoto M. Jones
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Martin E. Evans*
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC Lexington Veterans Affairs Healthcare System, Lexington, Kentucky Division of Infectious Diseases, Department of Internal Medicine, University of Kentucky School of Medicine, Lexington, Kentucky
Loretta A. Simbartl
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Stephen M. Kralovic
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC Cincinnati Veterans Affairs Healthcare System, Cincinnati, Ohio Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio
Marla Clifton
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Kathleen DeRoos
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Brian P. McCauley
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Natalie Gauldin
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Linda K. Flarida
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
Shantini D. Gamage
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio
Makoto M. Jones
Affiliation:
VA Salt Lake City Health Care System, Salt Lake City, Utah Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
Gary A. Roselle
Affiliation:
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC Cincinnati Veterans Affairs Healthcare System, Cincinnati, Ohio Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio
*
Author for correspondence: Martin E. Evans, E-mail: martin.evans@va.gov
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Abstract

Objective:

To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infections (HAIs) reported from 128 acute-care and 132 long-term care Veterans Affairs (VA) facilities.

Methods:

We compared central-line–associated bloodstream infections (CLABSIs), ventilator-associated events (VAEs), catheter-associated urinary tract infections (CAUTIs), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridioides difficile infections and rates reported from each facility monthly to a centralized database before the pandemic (February 2019 through January 2020) and during the pandemic (July 2020 through June 2021).

Results:

Nationwide VA COVID-19 admissions peaked in January 2021. Significant increases in the rates of CLABSIs, VAEs, and MRSA all-site HAIs (but not MRSA CLABSIs) were observed during the pandemic in acute-care facilities. There was no significant change in CAUTI rates, and C. difficile rates significantly decreased. There were no significant increases in HAIs in long-term care facilities.

Conclusions:

The COVID-19 pandemic had a differential impact on HAIs of various types in VA acute care, with many rates increasing. The decrease in CDI HAIs may be due, in part, to evolving diagnostic testing. The minimal impact of COVID-19 in VA long-term facilities may reflect differences in patient numbers and acuity and early recognition of the impact of the pandemic on nursing home residents leading to increased vigilance and optimization of infection prevention and control practices in that setting. These data support the need for building and sustaining conventional infection prevention and control strategies before and during a pandemic.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 3 , March 2023 , pp. 420 - 426
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Creative Commons
This is a work of the US Government and is not subject to copyright protection within the United States.
Copyright
© US Department of Veterans Affairs, 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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