Becker's Clinical Quality & Infection Control

31 QUALITY IMPROVEMENT & MEASUREMENT VA hospitals' antibiotic use has increased amid pandemic, study finds By Mackenzie Bean A ntibiotic use has increased at Veterans Affairs hospitals during the pandemic, reversing a four-year trend of reduced use, according to a study presented at IDWeek 2020. Researchers analyzed antibiotic use trends at 84 of the largest VA facilities in the U.S. be- tween January and May. ey also compared these trends to antibiotic use for the same five-month period from 2015 to 2019. Between 2015 and 2019, antibiotic use de- creased 1.5 percent annually at the VA facil- ities. However, researchers found antibiotic use jumped 4 percent in 2020, to 631 days of therapy per 1,000 patient days, up from about 605 per 1,000 patient days in 2019. "We are back up to rates last seen in 2016, so we've lost about three years of progress," lead author Matthew Goetz, MD, chief of infectious diseases at the VA Greater Los Angeles Healthcare System, said during an Oct. 23 media briefing. Dr. Goetz said the peak rate of antibiotic use appeared to occur sometime between March and April. He also said some VA hospitals with a large number of COVID-19 patients saw very few changes to antibiotic prescribing, while other facilities with few COVID-19 patients saw major changes. e findings highlight the importance of designing more resilient programs to help maintain antibiotic stewardship during cri- ses or future outbreaks, Dr. Goetz said. IDWeek 2020 is an annual meeting hosted by the Infectious Diseases Society of America, Society for Healthcare Epide- miology of America, the HIV Medical Association, the Pediatric Infectious Dis- eases Society and the Society of Infectious Diseases Pharmacists. The conference was held virtually this year. n COVID-19 patients with GI symptoms have worse outcomes, study finds By Erica Carbajal P atients experiencing gastrointestinal symp- toms from COVID-19 have an increased risk of hospitalization, ICU care and intubation compared to patients without GI symptoms, ac- cording to a study presented at the 2020 Ameri- can College of Gastroenterology Annual Scientific Meeting and Postgraduate Course. Patients with GI symptoms were found to be older, had higher body mass indexes, and had a higher occurrence of diabetes and hypertension. The study included data from 921 COVID-19 pa- tients treated at Rush University Medical Center in Chicago between March 12 and April 3. Of those patients, 206 (22.4 percent) reported at least one GI symptom. Nausea/vomiting was the most com- monly reported symptom, according to the study. Worsened outcomes were linked to GI symptoms after adjusting for demographics, comorbidi- ties and other clinical symptoms, according to researchers. "Translation of these results to clinical practice may involve additional focus on screening for GI symptoms to help better risk stratify COVID-19 positive patients," said Dr. Darbaz Adnan, study author, in a statement to Becker's. n 26-year-old COVID-19 patient once in vegetative state leaves hospital as survivor By Gabrielle Masson T ionna Hairston left Winston-Salem, N.C.-based Novant Health Rehabilitation Hospital Oct. 22 after suffering COVID-19 complications physicians deemed incurable, reported The Winston-Salem Journal. Ms. Hairston, 26, suffered a COVID-19 infection that contributed to a stroke, which caused bleeding in the brain and blood clots in her heart, according to Stacy Peatross, Ms. Hairston's mother. The woman required a ventilator for more than two months, along with a trach tube and collar. While being treated at Win- ston-Salem, N.C.-based Forsyth Medical Center's intensive care unit, Ms. Hairston experienced cardiac arrest. After being revived, her kidneys and liver began to fail. Physicians prepared Ms. Hair- ston's family for her death, saying the woman would probably be in a vegetative state for the rest of her life. In July, Ms. Hairston began to regain functionality in her kidneys and liver, which allowed her to leave the ICU, said Ms. Peatross. Ms. Hairston still has limited use of her arms and can only walk with a walker due to muscular atrophy. She is also suffering some memory loss. "She had every system in her body collapsed, everything shut down, and she's got most everything back," said James McLean, MD, medical director of the Novant Rehabilitation Hospital. n

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