502 - The Impact of Combating COVID-19 on Blood Culture Contamination and Central Line Associated Bloodstream Infection Rates

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Presenting Author(s)

Jennifer LeRose

Medical Student
Michigan State University College of Osteopathic Medicine
Beverly Hills, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

AS

Avnish Sandhu

Infectious Disease/Infection Control Antibiotic Stewardship Hospital Epidemiology Fellow
Department of Internal Medicine, Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JP

Jordan Polistico

Infectious Disease Fellow
Detroit Medical Center, Wayne State University
Detroit, MI
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JE

Joseph Ellsworth

HIM Corporate Data Management
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NB

Nancy Baran

Epidemiology Manager
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Canton, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MC

Mara Cranis

Infection Preventionist
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LJ

Lavina Jabbo

Infection Preventionist
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LC

Lori Cullen

Infection Preventionist
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JM

Judy Moshos

Epidemiology Manager
Department of Infection Control, Detroit Medical Center, Detroit, MI, USA
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TC

Teena Chopra

Corporate Medical Director of Infection Prevention and Hospital Epidemiology
Detroit Medical Center, Wayne State University
Detroit, MI
Disclosure: Spero Therapeutics (Consultant, Advisor or Review Panel member)

Background: Coronavirus disease (COVID-19) pandemic has presented challenges to every facet of the healthcare system. There is limited research evaluating the consequence of diverting resources from patient safety initiatives to COVID-19 crisis efforts. In an attempt to quantify the impact of COVID-19 on quality of patient care, we compared rates of blood culture contamination and central line associated bloodstream infections (CLABSIs) during COVID-19 to those before the pandemic.

Methods: A comparative retrospective cohort study was conducted to analyze blood culture contamination and CLABSI rate per 1,000 line days in a tertiary care hospital in Detroit within a “pre- COVID-19” timeframe, January - May 2019, and “COVID-19” timeframe, January - May 2020. The CLABSI rate data was obtained through Infection Control Surveillance System TheraDoc®. Blood culture contamination report was obtained through the Microbiology Department. Chi-square and t-test were used for statistical analysis.

Results: The blood culture contamination rate increased from 3.1% during pre COVID-19 timeframe to 4.0% during COVID-19 (p-value < 0.01) (Figure 1) with the highest rate in March and April 2020 correlating with the peak of COVID-19 (Figure 2). The CLABSI rate per 1,000 line days increased from 0.71 in pre-COVID-19 time frame to 2.70 during COVID-19 (p-value < 0.01) (Figure 1). Of the 33 CLABSIs identified during the COVID-19 time frame, 18 (54%) patients tested positive for COVID-19. When comparing COVID-19 positive and COVID-19 negative patients; average length of stay was 28.1 days shorter in the positive group (p-value < 0.01). COVID-19 positive patient had higher mortality (p-value < 0.01) (Table1). Refer to Table 1 for comparison of variables between pre COVID-19 and COVID-19 cohort and COVID-19 positive and negative cohort.Figure 1. Rate of blood culture contamination (top) and CLABSI per 1,000 Line Days Rate (below) Between Two Study Period (Pre COVID-19 and COVID-19)

Figure 2. Unique COVID Positive results in a Tertiary Care Center, Detroit, January-May 2020

Table 1. Characteristics of Entire Cohort

Conclusion: A 29% increase in blood culture contamination and 280% increase in CLABSI rate represents an enormous burden on healthcare resources and decreased quality. Despite no increase in length of stay in COVID-19 positive patient, higher mortality and CLABSIs were noted in these patients. During a pandemic, healthcare systems should be allocated additional resources to accommodate the increased patient load without affecting quality of care.