Hot Topics in IPC: Health Care Associated-Infections, COVID-19, Ebola, Dengue

Saskia v. Popescu, PhD, MPH, MA, CIC, discusses this weeks Hot Topics in Infection Prevention.

A rise in COVID-19 cases? Not particularly surprising…this is our third winter with COVID-19, so perhaps we’ll know what to do…better, this time?

Health Care Associated-Infections (HAIs)– Up in 2021

This isn’t surprising either, and for many individuals, this was expected based off personal experience, but it was nice to see the official data shared by the Centers for Disease Control and Prevention (CDC). Between the first year of the COVID-19 pandemic (2020) and last year (2021), the CDC reports through an annual highly that there was a 7% increase in central line-associated bloodstream infections (CLABSIs), a 5% increase in catheter-associated urinary tract infections (CAUTIs); both types of infections were notably in intensive care units (ICUs), but also a 12% increase in VAE with the biggest jump of 16% in non-ICUs.

Thankfully, there was not a significant change to surgical site infections (SSIs), but those were only in the 10 procedures tracked. The CDC did note an 11% increase in abdominal hysterectomy SSIs. Interesting, there was a 14% increase in hospital onset MRSA bacteremia and a 3% decrease in hospital onset Clostridioides difficile.What’s interesting is that if we look at the 2020 Progress Report (comparing 2019 to 2020), there was a 24% increase in CLABSIs, no significant change in CAUTIs, but a 35% increase in ventilator-associated events (VAEs).

What is even more interesting was the 15% increase in hospital onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and the 11% decrease in hospital onset C difficile. I mention this because it points to improvement in how we are managing HAIs in the face of the pandemic. The capacity to address a serious rise in HAIs in the second year of a pandemic, while rolling out vaccinations and managing novel variants, is a feat that has gotten little recognition. One piece, though, I find interesting is the from an 11% decrease in C difficile cases to 3% in this most recent report. It begs the question if we’ve overcorrected so much with discussions around cleaning and disinfection related to COVID-19 in the first year of the pandemic, that it’s rippled into our general behaviors and practices.

Masks – They Work!

A new study published in The New England Journal of Medicine presenting COVID-19 incidence among staff and students across schools in relation to universal masking. Keeping it short and sweet: When masking requirements were lifted, there was an associated increase in cases. According to the authors, “Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time.”

Elevator Updates on Ebola and Dengue!

The Ebola outbreak in Uganda has officially spread to a new region (eastern Uganda) and outside of the central region it had been mostly impacting, bringing the total cases to 135 confirmed and 53 deaths. Arizona has just reported a case of locally-acquired Dengue, which is worrisome for the state in which the virus does not traditionally exist. Mosquito trap surveillance confirmed the presence of the virus through a positive sample as well.