As the number of Covid cases increases, so does hospital-related infections


This news is frustrating, but it is not surprising to officials who have been watching waves of patients entering hospitals-in 2020, because there is no vaccine, there is almost no effective treatment; in 2021, because of vaccines be rejected. “In terms of healthcare-related infections and Covid, we really have a perfect storm,” said Arjun Srinivasan, physician and deputy director of the CDC’s infection prevention program.

He pointed out that in the first wave of infections, patients who are most likely to enter the hospital due to severe Covid are older, suffer from chronic diseases, and may have weakened immune functions-therefore, they are more likely to eventually be admitted to the ICU and require a ventilator to take over breathing. And enter their blood to deliver drugs. Faced with so many patients, medical staff are at a loss and are more likely to skip preventive tasks-and with such a shortage of PPE, they are more likely to unknowingly carry pathogens between patients. “So, at the same time, you have more patients than ever before, but you need fewer staff than usual to take care of them,” Srinivasan said. “The normal care delivery system has collapsed because your need for care is too great and there are not enough healthcare providers to provide it.”

There was an uneasy expectation last year that this might happen. In November, a team of researchers from New York and St. Louis Expected inside American Journal of Infection Control With the development of Covid, people who are mildly ill or who need to postpone surgery are less likely to go to the hospital for examination. They predict that this will lead to an increase in critically ill patients, who need interventions that lead to hospital infections. They made this prediction based on early signals from their own institution: In the first three months of the pandemic in the United States, compared with the previous 15 months, the central line-related bloodstream infections in one hospital increased by 420%, and the other increased by 420%. 327%.

“In my institution, Covid came to us in mid-March 2020, and April was the month with the worst nosocomial infection in our hospital history,” said Kathleen M. McMullen, senior manager of infection prevention and occupational health at Christian Hospital. Northwest Healthcare in St. Louis and the first author of the study. “When talking to colleagues across the country, we heard that they are also dealing with this problem and thought,’We need to solve this problem.'”

The team also foresees that with the delay of elective surgery, certain types of infections (such as infections in surgical incisions) will decrease. Their instincts are firm. CDC’s new data shows that the only type of nosocomial infection that declined last year was infection at the surgical site after colon surgery or hysterectomy (which requires an open incision instead of laparoscopic surgery), and This is difficult (hardWhen broad-spectrum antibiotics disrupt the balance of intestinal bacteria, malignant intestinal infections will surge.

Considering the conditions that hospitals endured in the first wave of the epidemic, all of this makes sense, McMullen said: “There are too many patients, no more medical staff, and too much fear – uncomfortable. I want to enter and leave the ward soon.”

The data discovered by CDC matches the data McMullen and her colleagues observed and then predicted.But she said it might actually be Underrepresented For hospital infections across the country, the work of caring for patients in the first wave was so intense that the Centers for Medicare and Medicaid Services allowed hospitals to suspend mandatory reporting from April to June.

There is a particularly ominous signal in the CDC data. One of the infections that surged between the end of 2019 and the end of last year was bacteremia-infectious bacteria that spread throughout the blood and can cause sepsis and septic shock-caused by MRSA. This is the only drug-resistant infection that appears in their data because it is one of the infections that CMS needs to report. (MRSA and all staphylococci live on the skin, so piercing the skin with a catheter or incision can introduce the bacteria into the body.)


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