Impact of COVID-19 on bloodstream infections in ICUs: Report from Indian HAI surveillance network

Objectives Blood stream infections (BSIs) are potentially fatal healthcare associated infections (HAIs). The COVID pandemic had a huge impact on hospital processes and health care outcomes. We studied the impact of COVID pandemic on the prevalence of ICU acquired BSIs in our established Indian HAI surveillance network. Material and methods This study included adult patients from ICUs in AIIMS HAI network that conducted BSI surveillance in COVID and non-COVID ICUs during and before the pandemic periods. Of the 40 hospitals in the network, ICUs from 16 hospitals conducted HAI surveillance in COVID ICUs and were included for the purposes of this study. Hospitals identified BSI and reported clinical and microbiological data to the network as per established and previously published protocols. Results A total of 1,863 events of BSI were identified during pre-pandemic and 2,571 events during pandemic period. During the pandemic, 557 (21.6%) were reported from COVID ICUs. The BSI rate during the pandemic was 8.9/1,000 patient days, and during pre-pandemic 5.4/1,000 patient days (P < 0.01). The central line associated BSI (CLABSI) rates increased from 9.2/1,000 central line days during the pre-pandemic period to 11.3/1,000 central line days during pandemic. Conclusion An increase in BSIs during the COVID pandemic was observed, which may be attributed to increased susceptibility of the patients or suboptimal infection control practices in COVID ICUs.