Incidence of central venous catheter-related bloodstream infections before, during, and after the SARS-CoV-2 pandemic: a registry-based cohort study.

BACKGROUND

While the SARS-CoV-2 pandemic generally was associated with more healthcare-associated infections (HAI) we found fewer central venous catheter (CVC)-related bloodstream infections (CRBSI) during the pandemic as compared to the time period before in patients mainly with haematological malignancies. Since data on post-pandemic HAI are scarce, we conducted an analysis focused on post-pandemic CRBSI. We hypothesised that the CRBSI incidence has increased again after the SARS-CoV-2 pandemic.

METHODS

For this cohort study, data were derived from a multicentre real-world registry on routine CVC surveillance in haematology and oncology departments in Germany. CRBSI ​​that occurred after and during the pandemic, respectively, were compared with those before the pandemic. Endpoints were CRBSI incidences and rates.

RESULTS

A total of 1474, 1079, and 692 CVC from the pre-pandemic, pandemic, and post-pandemic period, respectively, were analysed. CVC were mostly used in patients with haematological malignancies. Compared to the CRBSI incidence of the pre-pandemic and pandemic cohorts (3.9 and 1.9/1000 CVC days, respectively; p < 0.001), the CRBSI incidence of the post-pandemic cohort was similar to the incidence of the pre-pandemic cohort (3.3/1000 CVC days; p = 0.43). Likewise, the CRBSI rate declined during the pandemic (6.0% vs. 2.9%; p < 0.001) and increased afterwards to a level comparable to that from the pre-pandemic period (4.8%; p = 0.29). In multivariable analysis, the time periods before and after the pandemic were independent CRBSI risk factors.

CONCLUSIONS

Our data provide some evidence that following a temporary decline of CRBSI during the SARS-CoV-2 pandemic, CRBSI now returned to that observed in the pre-pandemic era.