Becker's Clinical Quality & Infection Control

6 INFECTION CONTROL Drug-resistant infection spiked at New Jersey hospital amid first COVID-19 surge, CDC finds By Erica Carbajal B etween February and July 2020, 34 patients at a New Jersey hospital acquired carbapenem-resistant Acinetobacter baumanni infection or colonization, according to the CDC's Dec. 1 Morbidity and Mortality Weekly Report. e bacteria can lead to pneumonia and wound, blood stream and urinary tract infections. Most CRAB infections were identified during the hospital's influx of COVID-19 patients between March and June. Of the 34 identified CRAB cases, 20 patients were diagnosed with an infection, including 14 with clinically diagnosed CRAB ventila- tor-associated pneumonia. At the time of the report, 23 patients were discharged, 10 died and one remained hospitalized. Shortages related to personal protective equipment, staff and other equipment during the COVID-19 patient surge in late March led the hospital to stray away from its usual infection prevention and control practices, which ultimately contributed to the out- break, according to the report. Before the pandemic, ventilator circuits and suctioning catheters were changed every 14 days and three days, respectively. During the COVID-19 surge, ventilator parts were only changed if they were visibly soiled or malfunctioning in an effort to conserve equipment. e hospital resumed standard IPC practices in late May when COVID-19 hospitalizations decreased, and CRAB cases also subsided. In August, no hospital-associ- ated CRAB cases were reported. "Facilities should prioritize continuity of core IPC practices to the greatest extent possible during surges in hospitalizations and make every effort to return to normal operating procedures as soon as capacity allows," the report said. n HAIs on rise amid pandemic, experts say By Mackenzie Bean M any infection preventionists said they've seen an uptick in healthcare-associated infections at their facilities since the pandemic's start, according to a Dec. 3 survey from the Association for Professionals in Infection Control and Epidemiology. The survey is based on 1,083 responses collected from infection preventionists nationwide between Oct. 22 and Nov. 5. Four survey findings: 1. Infection preventionists most commonly reported increased rates for central line-associated bloodstream infections (27.8 percent), catheter-associated urinary tract infections (21.4 percent) and ventilator-associat- ed pneumonia or ventilator-associated events (17.6 percent). 2. Nearly 73 percent of respondents said their facilities have implemented PPE crisis standards of care for respirators, while 68.7 percent said the same for masks and 75.8 percent for eye protection. 3. About 73 percent of infection preventionists said their facilities permit staff to reuse respirators for five days or more before they get new ones, and 73.6 per- cent reported the same for masks. 4. Seventy-two percent of infection preventionists said they were strongly or somewhat concerned about their facility's surge capacity. n Babies born via C-section at higher risk for infections, study suggests By Mackenzie Bean I nfants born via Cesarean section may be at higher risk of developing infections that require hospitalization, accord- ing to a study published Nov. 19 in PLOS Medicine. Researchers analyzed data on 7.2 million births in Denmark, Scotland, England and Australia between 1996 and 2015. About 1.7 million births were by C-section, of which 43 per- cent were elective. Researchers followed children through age 5 to determine how many were hospitalized for an infec- tion. Researchers controlled for several factors that may affect in- fection risk — like economic status, birthweight and gestational diabetes — but lacked data on breastfeeding, vaccination or postnatal smoke exposure, which could also affect rates. Overall, children born via an elective C-section had a 13 percent higher risk of an infection-related hospitalization than those born vaginally. This risk was 9 percent higher for chil- dren born via an emergency C-section. Infection rates were highest for respiratory, gastrointestinal and viral infections. "This is not about telling women how to deliver, or making them feel guilty about how they deliver their babies," senior author David Burgner, PhD, a senior research fellow at the Murdoch Children's Research Institute in Melbourne, Australia, told The New York Times. "That decision is for the woman in consultation with her doctor. This is a large-scale observation- al study that shows a small but consistent risk." n

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