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What’s New in the
Patient Safety World
August 2022
Resistant
Infections Up During COVID-19 Pandemic
The COVID-19
pandemic has had a significant impact on hospital infections. In our October
2021 What's New in the Patient Safety World column “HAI’s Increase During
COVID-19 Pandemic” we noted
that during the pandemic there were significant national increases in CLABSI’s (central
line–associated bloodstream infections), CAUTI’s (catheter-associated urinary
tract infections), VAE’s (ventilator-associated events), and MRSA infections.
In addition, there has been a substantial increase in antimicrobial resistance since the pandemic began. CDC (CDC 2022) reports that resistant hospital-onset infections and deaths both increased at least 15% from 2019 to 2020 among seven pathogens:
- 78% increase in carbapenem-resistant Acinetobacter
- 32% increase in multidrug-resistant Pseudomonas aeruginosa
- 14% increase in infections in vancomycin-resistant Enterococcus
- 13% increase in methicillin-resistant Staphylococcus aureus.
Antifungal-resistant
threats rose in 2020, too, including Candida auris
(60% increase) and other Candida species (26% increase) in infections in
hospitals.
During the first year
of the pandemic, more than 29,400 people died from antimicrobial-resistant
infections commonly associated with healthcare. Of these, nearly 40% of the
people got the infection while they were in the hospital.
CDC notes that
hospitals treated sicker patients who required more frequent and longer use of
medical devices like catheters and ventilators. Hospitals also experienced
personal protective equipment supply challenges, staffing shortages, and longer
patient visits.
CDC hopes that the
trend is temporary but notes we must invest in the prevention-focused public
health actions that we know work, such as accurate laboratory detection, rapid
response and containment, effective infection prevention and control, and
expansion of innovative strategies to combat antimicrobial resistance. Those
strategies include alternatives to antibiotics and antifungals, new vaccines to
combat infections that can develop antimicrobial resistance, and novel
decolonizing agents to stop the spread of antimicrobial-resistant germs by
people who may not know they are carriers.
Some of our prior columns on antibiotic stewardship:
- October 14, 2014 “Antibiotic Stewardship”
- November 2015 “Medications Most Likely to Harm the Elderly Are…”
- July 2016 “NQF/CDC Guideline on
Antibiotic Stewardship”
- August 2016 “Some Reassurance on
Antibiotic Stewardship”
- November 2016 “C. Diff and Your
Predecessor’s Room”
- December 2016 “Update on Ambulatory
Antibiotic Stewardship”
- July 2017 “Antibiotics and Adverse
Events”
- July 2019 “Dental Prescribing
Called Into Question”
- July 21, 2020 “Is This Patient
Allergic to Penicillin?”
- March 30, 2021 “Need for Better
Antibiotic Stewardship”
- August 2021 “Antibiotic Stewardship
in Pediatrics”
- May 24, 2022 “Requiring Indication
for Antibiotic Prescribing”
See also our other
columns related to COVID-19:
- April 7, 2020 “Patient Safety Tidbits
for the COVID-19 Pandemic”
- May 5, 2020 “COVID-19 and the Dental
Office”
- May 12, 2020 “Lab Errors and COVID-19”
- June 16, 2020 “Tracking Technologies”
- November
2020 “Telemedicine
Here to Stay But Use It Safely”
- December 2020 “ISMP Warns of Vaccine
Errors as We Gear Up for COVID-19 Vaccines”
- January 26, 2021 “This Freezer Accident
May Cost Lives”
- September 2021 “Have You Added Pandemic
Preparation to Your Hospital Disaster Plan?”
- October 2021 “HAI’s Increase During
COVID-19 Pandemic”
- January 2022 “Some COVID-19 Practices
May Outlast the Pandemic”
- April 2022 “Another Benefit from
the COVID-19 Pandemic?”
- May 2022 “ECRI Top 10 Patient
Safety Concerns for 2022”
References:
CDC (Centers for Disease Control and Prevention). COVID-19. U.S. Impact on Antimicrobial Resistance. 2022 Special Report. CDC 2022
https://www.cdc.gov/drugresistance/covid19.html
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