Becker's Clinical Quality & Infection Control

5 INFECTION CONTROL Sharp drop in patient safety, infection control amid pandemic: 3 findings By Gabrielle Masson S ince the COVID-19 pandemic began, metrics tracking healthcare-associated infections and other care complica- tions indicate significant deterioration of multiple patient safety measures, according to an analysis published Feb. 12 by e New England Journal of Medicine. e healthcare industry has struggled to understand exactly how patient safety and care quality have been affected amid the pandemic, with national data oen lagging by several quarters to a year. e first hint came in September 2021, when the CDC published a report that found healthcare-associated infections increased significantly in 2020 aer years of steady decline. Now, multiple studies cited by e New England Journal of Med- icine offer a clearer picture of the pandemic's impact on patient safety and infection control — and it's not pretty. ere are numerous potential explanations for the increase in adverse events, according to the analysis authors, including but not limited to vast numbers of very ill patients, staff burnout and shortages, and supply chain disruptions. ree findings to know: 1. Central line-associated bloodstream infections in U.S. hospitals increased 28 percent in the second quarter of 2020, compared to the second quarter of 2019, according to CDC data. In the five years preceding the pandemic, central line-associated bloodstream infections had decreased by 31 percent. 2. A study of 148 HCA Healthcare-affiliated hospitals through 2020 found central line-associated bloodstream infections, cath- eter-associated urinary tract infections, and methicillin-resistant staphylococcus aureus bacteremia all increased as the COVID-19 burden increased. Here are increases for the following infections over seven months of 2020: Central line-associated bloodstream infections: 60 percent increase Methicillin-resistant Staphylococcus aureus: 44 percent increase Catheter-associated urinary tract infections: 43 percent increase 3. Rates of hospital-onset bloodstream infections and multidrug resistant organisms, vancomycin-resistant enterococcus and Gram-negative organisms were each significantly associated with COVID-19 surges, the study found. There are numerous potential explanations for the increases in adverse events, including but not limited to, vast numbers of very ill patients, staff burnout and shortages, and supply chain disruptions. n Experts call for universal vaccine in anticipation of future variants By Erica Carbajal C hasing the latest circulating COVID-19 variant with a targeted vaccine isn't a viable pandemic strategy, experts say, instead calling for an Operation Warp Speed approach for the development of a universal vac- cine, The Washington Post reported Feb. 15. Drugmakers have created variant-specific vaccines for beta, delta and omicron, but many scientists say it's a game of catch-up and unsustainable in the long-term. "You don't want to play this whack-a-mole approach," David Martinez, PhD, a viral immunologist at the University of North Carolina at Chapel Hill, told the Post. "This could go on forever." Dr. Martinez is working on a vaccine that shows the immune system "chimeric" spikes — spikes that patch to- gether fragments from SARS-CoV-2, a bit from the original SARS virus, and another component from a bat coronavirus. Now, many scientists are working on designing a type of variant-proof vaccine, aiming to offer broad protection for existing variants and those yet to emerge. "We're looking for a tetanus-like shot," said Barton Haynes, MD, immunology and vaccine expert at Duke University School of Medicine in Durham, N.C. "We all have to get a tetanus shot every 10 years. That would be really terrific," he told the Post. Crafting a shot that offers broad protection, however, means overcoming a lot of hurdles, as it requires a more layered and complex approach than the first versions of the vaccine targeting the SARS-CoV-2 virus that emerged in 2019. "You shouldn't confuse the rapidity and the ease with which we developed a coronavirus vaccine for SARS-CoV-2 with the extraordinary obstacles you might face in trying to get a vaccine that protects" more broadly, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told the Post. "There's a lot of scientific discovery that needs to go into that." The amount of challenges creating a truly universal vaccine presents can be seen in the decades spent trying to create universal influenza vaccines. "We have been studying influenza viruses more than 70 years, and we are trying to make universal influenza vac- cines, and we still haven't been able to do it," said Yoshihiro Kawaoka, PhD, a virologist who is working on a pan-corona- virus vaccine at the University of Wisconsin at Madison. "But this is a different virus, and I think it's worth trying. What I'm trying to say is that it may not be easy," he told the Post. n

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