Background: This study examines the impact of the COVID-19 pandemic on healthcare-associated infection (HAI) incidence in low-to-middle-income countries (LMICs).
Methods: Patients from 7 LMICs were followed during hospital intensive care unit (ICU) stays throughout January 2019 to May 2020. HAI rates were calculated using the INICC Surveillance Online System applying CDC-NHSN criteria. Pre-COVID-19 rates for 2019 were compared to COVID-19 era rates for 2020 for central line associated bloodstream infections (CLABs), catheter associated urinary tract
infections (CAUTIs), ventilator associated events (VAEs), mortality and lengths of stay (LOS).
Results: 7,775 patients were followed for 49,506 bed-days. 2019 to 2020 rate
comparisons: 2.54 and 4.73 CLABSIs per 1,000 central line days (RR=1.85, p =0.0006), 9.71 and 12.58 VAEs per 1,000 mechanical ventilator days (RR=1.29, p =0.10), 1.64 and 1.43 CAUTIs per 1,000 urinary catheter days (RR=1.14; p = 0.69).
Mortality rates were 15.2% and 23.2% for 2019 and 2020 (RR=1.42; p < 0.0001).
Mean LOS were 6.02 and 7.54 days (RR=1.21, p < 0.0001).
Discussion: This report documents a rise in HAI rates in 7 LMICs during the first 5 months of the COVID-19 pandemic and highlights the need to reprioritize and return to conventional infection prevention practices.