Kihan Yap, Kyaw Zaw Linn, Allie Yin Lim, Xiaowei Huan, Nicholas Bao Han Hang, Louisa Sun, Si Huei Tan, Koh Cheng Thoon, Brenda Sze Peng Ang, Moi Lin Ling, Surinder Kaur Pada, Albert Ty, Dale Fisher, Kalisvar Marimuthu
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引用次数: 0
Abstract
Background: Multidrug-resistant organisms (MDROs) and hospital-acquired infections (HAIs) threaten patient safety. Transmission-based precautions (TBPs) are critical infection prevention and control (IPC) measures but resource-intensive. The COVID-19 pandemic disrupted routine IPC practices due to resource diversion for pandemic response, straining systems and compromising TBPs for pathogens of interest (POIs). This study analysed IPC practices in five Singapore acute hospitals before and during the COVID-19 pandemic from August 2020 to August 2021.
Aim: This study investigated the impact of the COVID-19 pandemic on the implementation of pathogen-specific TBP.
Methods: The primary outcome measure was the proportion of patients on appropriate pathogen-specific transmission-based precautions (TBP). We compared the variables between the two cycles to assess the impact of COVID-19 on the implementation of pathogen-specific IPC measures.
Findings: A total of 8601 patient records were reviewed (4132 in Cycle 1 and 4469 in Cycle 2). Appropriate TBP implementation decreased by 39% during Cycle 2 compared to Cycle 1 (OR, 0.61; 95% CI, 0.50-0.73; p<0.01). Staff unawareness of pathogens of interest (POIs) emerged as the most common factor contributing to inappropriate TBP placement across both cycles. Notably, patients with MRSA only experienced a significant decrease in appropriate TBP during Cycle 2 (OR, 0.56; 95%CI, 0.44-0.71; p<0.01). Interestingly, hospitals with higher pre-pandemic TBP adherence rates maintained better compliance during the pandemic.
Conclusion: The COVID-19 pandemic adversely affected the implementation of appropriate TBPs in Singapore acute care hospitals. This study highlights the need to act proactively to maintain appropriate TBPs during public health emergencies.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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