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Unintended consequences of infection prevention and control measures during COVID-19 pandemic.
Wee, Liang En Ian; Conceicao, Edwin Philip; Tan, Jing Yuan; Magesparan, Kamini Devi; Amin, Ismawati Binte Mohamad; Ismail, Bushra Binte Shaik; Toh, Hui Xian; Jin, Pinhong; Zhang, Jing; Wee, Elaine Geok Ling; Ong, Sheena Jin Min; Lee, Gillian Li Xin; Wang, Amanda En-Min; How, Molly Kue Bien; Tan, Kwee Yuen; Lee, Lai Chee; Phoon, Poh Choo; Yang, Yong; Aung, May Kyawt; Sim, Xiang Ying Jean; Venkatachalam, Indumathi; Ling, Moi Lin.
  • Wee LEI; Singhealth Infectious Diseases Residency, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore. Electronic address: ian.wee@mohh.com.sg.
  • Conceicao EP; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Tan JY; Department of Internal Medicine, Singapore General Hospital, Singapore.
  • Magesparan KD; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Amin IBM; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Ismail BBS; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Toh HX; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Jin P; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Zhang J; Department of Nursing Speciality Care Unit, National Heart Centre, Singapore.
  • Wee EGL; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Ong SJM; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Lee GLX; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Wang AE; Department of Nursing Speciality Care Unit, National Heart Centre, Singapore.
  • How MKB; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Tan KY; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Lee LC; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Phoon PC; Department of Nursing Speciality Care Unit, National Heart Centre, Singapore.
  • Yang Y; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Aung MK; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Sim XYJ; Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Venkatachalam I; Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
  • Ling ML; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore. Electronic address: ling.moi.lin@singhealth.com.sg.
Am J Infect Control ; 49(4): 469-477, 2021 04.
Article in English | MEDLINE | ID: covidwho-907189
Semantic information from SemMedBD (by NLM)
1. Signs and Symptom PROCESS_OF C0030705
Subject
Signs and Symptom
Predicate
PROCESS_OF
Object
C0030705
2. Cross Infection CAUSES COVID-19
Subject
Cross Infection
Predicate
CAUSES
Object
COVID-19
3. Infection COEXISTS_WITH C0035243
Subject
Infection
Predicate
COEXISTS_WITH
Object
C0035243
4. Signs and Symptoms, Respiratory PROCESS_OF Patients
Subject
Signs and Symptoms, Respiratory
Predicate
PROCESS_OF
Object
Patients
5. Cross Infection CAUSES COVID-19
Subject
Cross Infection
Predicate
CAUSES
Object
COVID-19
6. Infections, Hospital COEXISTS_WITH Respiratory Tract Infections
Subject
Infections, Hospital
Predicate
COEXISTS_WITH
Object
Respiratory Tract Infections
ABSTRACT

BACKGROUND:

In the current COVID-19 pandemic, aggressive Infection Prevention and Control (IPC) measures have been adopted to prevent health care-associated transmission of COVID-19. We evaluated the impact of a multimodal IPC strategy originally designed for the containment of COVID-19 on the rates of other hospital-acquired-infections (HAIs).

METHODOLOGY:

From February-August 2020, a multimodal IPC strategy was implemented across a large health care campus in Singapore, comprising improved segregation of patients with respiratory symptoms, universal masking and heightened adherence to Standard Precautions. The following rates of HAI were compared pre- and postpandemic health care-associated respiratory-viral-infection (HA-RVI), methicillin-resistant Staphylococcus aureus, and CP-CRE acquisition rates, health care-facility-associated C difficile infections and device-associated HAIs.

RESULTS:

Enhanced IPC measures introduced to contain COVID-19 had the unintended positive consequence of containing HA-RVI. The cumulative incidence of HA-RVI decreased from 9.69 cases per 10,000 patient-days to 0.83 cases per 10,000 patient-days (incidence-rate-ratio = 0.08; 95% confidence interval [CI] = 0.05-0.13, P< .05). Hospital-wide MRSA acquisition rates declined significantly during the pandemic (incidence-rate-ratio = 0.54, 95% CI = 0.46-0.64, P< .05), together with central-line-associated-bloodstream infection rates (incidence-rate-ratio = 0.24, 95% CI = 0.07-0.57, P< .05); likely due to increased compliance with Standard Precautions. Despite the disruption caused by the pandemic, there was no increase in CP-CRE acquisition, and rates of other HAIs remained stable.

CONCLUSIONS:

Multimodal IPC strategies can be implemented at scale to successfully mitigate health care-associated transmission of RVIs. Good adherence to personal-protective-equipment and hand hygiene kept other HAI rates stable even during an ongoing pandemic where respiratory infections were prioritized for interventions.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Infection Control / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Am J Infect Control Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Infection Control / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Am J Infect Control Year: 2021 Document Type: Article