VRE bloodstream infections increase in California hospitals amid COVID-19
The incidence of vancomycin-resistant enterococci bloodstream infections significantly increased in California hospitals during the second and third quarter of 2020 compared with the same period in 2019, a report showed.
However, there was “insufficient evidence” to indicate significant changes in the incidence of more common infections — Clostridioides difficile infection (CDI) and methicillin-resistant Staphyloccocus aureus (MRSA) bloodstream infections (BSIs) — in these hospitals during the COVID-19 pandemic, researchers reported.
The findings were presented at the virtual SHEA Spring Conference.
Andrea Parriott, MPH, PhD, study author and a research scientist with the health care-associated infections program within the California Department of Public Health (CDPH), told Healio Primary Care there were concerns that “potential shortages and reuse of personal protective equipment, increased use of antibiotics and general diversion of resources from infection prevention activities during the pandemic might impact the progress California hospitals have made in reducing the incidence of other health care-associated infections.”
Therefore, Parriott and colleagues culled data reported by hospitals in California to the National Healthcare Safety Network to analyze standard incidence rate ratios (SIR) for vancomycin-resistant enterococci (VRE) BSI, CDI and MRSA BSI.
The researchers reported that the crude incidence rate of VRE BSI increased during the second and third quarter of 2020 compared with the same period in 2019 (SIR = 1.4; 95% CI, 1.16-1.7). However, there were no statistically significant changes in SIRs for either MRSA BSI or CDI between 2015 and the second and third quarter of 2020.
Parriott said that while the findings regarding VRE BSI could be due to differences in patients’ risk profiles, “for CDI and MRSA BSI, we say there was insufficient evidence of a change in incidence, rather than stating that the rate remained unchanged.”
This distinction is “important because the CDC has created risk-adjustment models (which take into account hospital characteristics and patient mix) for CDI and MRSA BSI but not for VRE BSI,” Parriott continued.
She added that CDPH has not dismissed the possibility that California’s recent improvements in reducing CDI and MRSA BSI in hospitals has been setback during the pandemic.
“CDPH is using the results of these analyses to inform and prioritize our prevention outreach and technical assistance to hospitals moving forward,” she said.