Healthcare-Associated Infections in Veterans Affairs Acute and Long-Term Healthcare Facilities During the Coronavirus Disease 2019 (COVID-19) Pandemic.

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: Central line-associated bloodstream infections (CLABSIs), ventilator-associated events (VAEs), catheter-associated urinary tract infections (CAUTIs), and 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) were compared. 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 period 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 the pandemic had 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 c ontrol strategies before and during a pandemic.