171. The Impact of COVID-19 on Healthcare-Associated Infections

Abstract Background The profound changes wrought by COVID-19 on routine hospital operations may have influenced performance measures, including healthcare-associated infections (HAIs). Objective Evaluate the association between surges and HAI or cluster rates Methods Design: Prospective cohort study Setting 148 HCA Healthcare-affiliated hospitals, 3/1/2020-9/30/2020, a subset of hospitals with microbiology data through 12/31/2020 Patients All inpatients Measurements We evaluated HAIs, hospital-onset pathogens, using negative binomial mixed models. To account for local variation in pandemic surge timing, we included number discharges laboratory-confirmed diagnosis per staffed bed month at each hospital. Results Central line-associated blood stream (CLABSI), catheter-associated urinary tract (CAUTI), methicillin-resistant Staphylococcus aureus (MRSA) bacteremia increased as burden (P ? 0.001 all), 60% (95% CI, 23 to 108%) more CLABSI, 43% 8 90%) CAUTI, 44% 10 88%) cases MRSA than expected over 7 months based predicted HAIs had there not been cases. Clostridioides difficile infection (CDI) was significantly associated burden. Microbiology from 81 corroborated findings. Notably, bloodstream multidrug resistant organisms, MRSA, vancomycin-resistant enterococcus Gram-negative organisms were < 0.05 all). Finally, clusters pathogens = 0.02). Limitations Variations surveillance reporting affect data. Table 1. Effect an increase Figure Predicted mean rate increasing monthly discharges. Panel a. b, CAUTI c. Bacteremia, d. CDI. Data are stratified small, medium large hospitals. 2. Monthly comparison COVID correlated throughout pandemic. Conclusion adversely impact within emphasizing need balancing COVID-related demands prevention. Disclosures Kenneth Sands, MD, MPH, Medline (Other Financial Material Support, Conducted studies which participating received contributed antiseptic product) Susan S. Huang, nursing homes cleaning products)Molnlycke products)Stryker (Sage) products)Xttrium products) Ken Kleinman, PhD, Edward Septimus, Eunice J. Blanchard, MSN RN, Russell Poland, Micaela H. Coady, MS, product)Molnlycke Deborah Yokoe, Nothing disclose Julia Moody, Richard Platt, MSc, (Research Grant Other Jonathan B. Perlin,