As COVID cases increase, so does hospital-related infection

Excessive crowding of COVID care can lead to increased infection. Last month, a 46-year-old soldier died in Houston of pancreatitis, an emergency but treatable condition, while waiting to be admitted to hospital drowning in unvaccinated COVID patients. Hawaii's governor last week signed an executive order to separate state hospitals if patients were not accepted because they had no room. The Idaho Department of Health announced Monday the Critical Care Standards, a triage system that allows hospitals without extra beds to decide which patients should be admitted.

Meanwhile, a Florida high school teacher went viral after she described how she took her 12-year-old to the emergency room who drowned with COVIOD patients. They waited six hours for her baby's appendix to rupture, a potentially life-threatening event. His son survived - after what his father described as five days in the hospital and a $5,000 pro forma bill.

The story of patients who could not be admitted to hospital - stuck in waiting rooms, delayed in ambulances and taken to hospital alive. Other states that might have an open bed - have been consistently hot this summer. Overcrowding is a clear threat to their health. But it poses a more subtle threat to previously admitted patients: it creates conditions and demands for hospital staff that allow dangerous infections to spread. As COVID cases increase, hospital-associated infections increase Now, a new study shows just how true This threat, based on infection statistics from hospitals that battled the first wave of COVID in 2020. Analysis published last week by the Centers for Disease Control and Prevention in the journal Infection Control and Hospital Epidemiology, shows that the pressure of COVID patient care has undermined years of progress. in the prevention of nosocomial infections. By 2020, according to a federal registry that collects data from thousands of hospitals, emergency care centers, and outpatients, there will be a sharp and persistent increase in catheter-related blood and urinary tract infections and respiratory pneumonia — including infections — there. It is caused by drug-resistant staphylococcus aureus, more commonly known as MRSA. Patients become susceptible to infection when severe illness weakens their immune system or requires treatment in an intensive care unit in the presence of other patients. Health care workers can inadvertently transfer pathogens from one patient to another, and rescue equipment such as catheters and breathing tubes can also enter the body.

This infection is one of the most serious consequences of hospitalization, especially in intensive care; They can make 1 in 5 patients unlucky. In the 2000s, citizen rights advocates reported that one in 20 patients had one of these infections each year, causing more than one million unnecessary illnesses and deaths each year, and billions of dollars in additional costs to the health care and system. There will be a federal refund. Their pressure on the legislature and Congress led to a mandatory reporting and national action plan created in 2013, forcing health care providers to reduce the conditions — staff behavior, treatment algorithms, and types of equipment — that cause infection. Real progress has been made. Since 2015, rates of the most common conditions and deaths, including respiratory pneumonia, catheter-related infections, and incisional infections, have been declining.


Until the coronavirus outbreak. The pandemic has overwhelmed deeply frustrated patients who needed rescue equipment in the intensive care unit and underwent health care that lacked adequate protective equipment — in other words, creating a situation where hospital infections could surge. Between the end of 2019 and the end of 2020, according to the Centers for Disease Control and Prevention, injuries involving blood catheters, known as CLABSIs, increased 47%. Pulmonary and other ventilator-related infections increased by 44.8%. Catheter-related urinary tract infections increased by 18.8%.

This is troubling news, but not surprising for officials who swept through a wave of hospitalized patients in 2020, when vaccines and treatments were not effective. In 2021, because vaccines will be rejected. "We've really gone through a whole storm of healthcare-related infections and Covid." They are severely ill, elderly, have chronic diseases and possibly immunodeficiency - and as a result, they are more likely to be in the intensive care unit and need ventilators to breathe in and out. Blood Flow to Deliver Drugs Despite the large number of patients, health care workers were extremely vulnerable, at greater risk of escaping from protective action—and with PPE in such a shortfall, they were more likely to inadvertently transmit pathogens between patients. "At the same time you have more patients than before, you have fewer staff than usual." You don't have that.

Last year this was expected to fall. In November, a team of researchers from New York and St. Louis at the American Infection Control Organization predicted that as Covid progresses, people Those with fewer acute illnesses or late surgery would be less likely to go to hospital.They predicted that this would lead to an increase in the number of severely ill patients who would need a variety of interventions leading to hospital infections.They made a prediction based on early signals from their institutions: In the first three months of the US epidemic, central line bloodstream infections increased by 420 percent in one hospital and 327 percent in another in the past 15 months.

“In my organization, COVID has come to us. In mid-March 2020, April was the worst month for hospital infections in hospital history,” said Kathleen M. McMullen, senior director of occupational prevention and infection at the Christian Hospital and Northwest Healthcare Study in St. Louis and first author. National, we hear they enjoy We hoped with her too, and we thought, 'We have to solve this problem.' “In surgical incisions, they are reduced by delaying elective surgeries. Their instincts were strong. New CDC data shows that the only types of nosocomial infections reduced last year were postoperative surgical site infections. Large hysterectomies or hysterectomies (the kind that require Open) the incision, not laparoscopy) as well as Clostridium difficile, is dangerous in the gut, and when the infection is affected by a wide range of intestinal bacteria, the infection increases.” McMullen said. Inconvenient, wants to get in and out of the patient's room quickly. Then he predicted, but he said there might actually be fewer infections in hospitals across the country, because patient care in the first wave was so intense that the Federal Center for Health and Medical Services allowed hospitals to file mandatory reports. Predictive signal in Centers for Disease Control and Prevention (CDC) data. One infection that increased by a third between the end of 2019 and the end of last year was bacteremia - the spread of bacteria. Infection in the bloodstream, which can lead to sepsis and septic shock - caused by MRSA, was the only drug-resistant infection featured in their data because it is among the infections that CMS has to report. MRSA and all Staph bacteria live on the skin, so puncturing it with a catheter or incision can draw the bacteria into the body.)

But MRSA isn't the only drug-resistant infection At the start of the pandemic, researchers were concerned about the experimental use of the antibiotics. Vitality - due to misunderstanding, rather than experience. Laboratory - This increasingly prevents the possibility of bacterial pneumonia in COVID patients when using the respiratory system or intensive care unit. Of course, antibiotics do not cure COVID-19. But its presence in the patient's body that receives it may make other bacteria resistant to the drugs.

These concerns have now been confirmed by the data. The Pew Charity reported in March that, based on a database of 6,000 admission records, more than half of patients admitted in the early months of the pandemic had received at least one antibiotic. The third received multiple copies. Nearly all, 96 percent, received the first antibiotic that was faster than a lab test on any bacterial pathogen, which has raised concerns about experimental prescriptions that may therefore be unnecessary. At the same time, the increase in telehealth, which can also make experimental prescriptions possible, has led to an increase in the number of outpatient prescriptions. Last winter, Srinivasan told a federal delegation that the CDC surveyed 20 outbreaks of COVID treatment units between April 2020 and February 2021. These included outbreaks of Acinetobacter baumanii in New Jersey and Candida auris in Florida, both of which were resistant to drugs of last resort. There are places in the United States where the rate of cases is higher now than it was at any time during the pandemic. Even with the addition of personal protective equipment, the pressure to care for many patients is very strong. The overcrowding of intensive care units and the emotional loss of the fourth wave create a situation in which nosocomial infections continue to spread. Says Cornelius J. Clancy, MD, a hospital physician and associate professor of medicine: "This is cunning pressure." At the University of Pittsburgh, “Healthcare workers have been working at full capacity for 18 months. The workforce is tight. People are running away. We usually go to the busiest time of the year in the hospital.”: Vaccination. The fewer critically ill patients in intensive care, and the fewer staff there are, the lower the risks. Because it takes them away from the hospital and reduces system stress, so we can go back to implementing all the methods we know work. "We don't normally consider the use of the COVID vaccine to prevent nosocomial infections, but it is the most important tool we have at the moment."

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As COVID cases increase, so does hospital-related infection
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