Infection control and hospital epidemiology · 2025
Trends of bloodstream infection incidence rates among patients on outpatient hemodialysis, National Healthcare Safety Network, 2012-2021.
СтатьяНазвание и аннотация: Перевод в очереди
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Li Qunna, Novosad Shannon, Rha Brian, Hua Hannah, Fike Lucy, Navarrete Jose, Meng Lu, Benin Andrea, Edwards Jonathan, Bell Jeneita
Аннотация
OBJECTIVE: The purpose of the study is to analyze bloodstream infection (BSI) data reported by outpatient hemodialysis facilities to understand temporal trends, the potential impact of infection prevention practices and the COVID-19 pandemic on BSI rates.
METHODS: Outpatient hemodialysis facilities report BSI data to the National Healthcare Safety Network. We used interrupted time series with mixed effects negative binomial modeling to estimate the annual change of BSI rates from 2012 to 2021, using March 2020 as the COVID-19 inflection point. The model controlled for seasonal factors, vascular access types, and facility characteristics.
RESULTS: The number of facilities used for analysis increased from 5,581 in 2012 to 7,313 in 2021. Most facilities were freestanding (range: 90%-93%) and belonged to for-profit organizations (range: 85%-88%). The annual adjusted BSI rates decreased by an average of 8.90% (95% CI: -9.10 %, -8.71%) January 2012-February 2020. The annual decrease in BSI rate was not significant during March 2020-December 2021 (P = 0.15). There was a level drop of 32.03% (95%CI: -33.84%, -30.17%) in BSI rates in the period of March 2020-December 2021 compared with the period of January 2012-February 2020.
CONCLUSIONS: BSI rates decreased steadily from January 2012 to February 2020 likely due to the identification and adoption of evidence-based prevention practices. BSI rates plateaued at lower levels during March 2020-December 2021. This suggests that infection prevention measures implemented by facilities prior to the emergence of COVID-19 contributed to substantial decreases in BSI rates and may have helped to stabilize BSI rates after March 2020.
METHODS: Outpatient hemodialysis facilities report BSI data to the National Healthcare Safety Network. We used interrupted time series with mixed effects negative binomial modeling to estimate the annual change of BSI rates from 2012 to 2021, using March 2020 as the COVID-19 inflection point. The model controlled for seasonal factors, vascular access types, and facility characteristics.
RESULTS: The number of facilities used for analysis increased from 5,581 in 2012 to 7,313 in 2021. Most facilities were freestanding (range: 90%-93%) and belonged to for-profit organizations (range: 85%-88%). The annual adjusted BSI rates decreased by an average of 8.90% (95% CI: -9.10 %, -8.71%) January 2012-February 2020. The annual decrease in BSI rate was not significant during March 2020-December 2021 (P = 0.15). There was a level drop of 32.03% (95%CI: -33.84%, -30.17%) in BSI rates in the period of March 2020-December 2021 compared with the period of January 2012-February 2020.
CONCLUSIONS: BSI rates decreased steadily from January 2012 to February 2020 likely due to the identification and adoption of evidence-based prevention practices. BSI rates plateaued at lower levels during March 2020-December 2021. This suggests that infection prevention measures implemented by facilities prior to the emergence of COVID-19 contributed to substantial decreases in BSI rates and may have helped to stabilize BSI rates after March 2020.