The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of the coronavirus disease 2019 pandemic on the incidence of other infectious diseases in the hematology hospital in Korea

  • Seohee Oh (Catholic Medical Center, College of Medicine, The Catholic University of Korea) ;
  • Yu-Sun Sung (Catholic Medical Center, College of Medicine, The Catholic University of Korea) ;
  • Mihee Jang (Catholic Medical Center, College of Medicine, The Catholic University of Korea) ;
  • Yong-Jin Kim (Catholic Medical Center, College of Medicine, The Catholic University of Korea) ;
  • Hyun-Wook Park (Catholic Medical Center, College of Medicine, The Catholic University of Korea) ;
  • Dukhee Nho (Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Dong-Gun Lee (Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Hyeon Woo Yim (Department of Preventive Medicine, College of Medicine, The Catholic University of Korea) ;
  • Sung-Yeon Cho (Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2023.11.19
  • Accepted : 2024.02.05
  • Published : 2024.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background/Aims: Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units. Methods: This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic. Results: The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively). Conclusions: The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.

Keywords

Acknowledgement

Statistical consultation was supported by the Department of Biostatistics of the Catholic Research Coordinating Center.

References

  1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733.
  2. Lai S, Ruktanonchai NW, Zhou L, et al. Effect of non-pharmaceutical interventions to contain COVID-19 in China. Nature 2020;585:410-413.
  3. COVID-19 National Emergency Response Center, Epidemiology & Case Management Team, Korea Centers for Disease Control & Prevention. Contact transmission of COVID-19 in South Korea: novel investigation techniques for tracing contacts. Osong Public Health Res Perspect 2020;11:60-63.
  4. Cho SY, Park SS, Lee JY, et al. Successful prevention and screening strategies for COVID-19: focus on patients with haematologic diseases. Br J Haematol 2020;190:e33-e37.
  5. Stevens MP, Doll M, Pryor R, Godbout E, Cooper K, Bearman G. Impact of COVID-19 on traditional healthcare-associated infection prevention efforts. Infect Control Hosp Epidemiol 2020;41:946-947.
  6. Hu LQ, Wang J, Huang A, Wang D, Wang J. COVID-19 and improved prevention of hospital-acquired infection. Br J Anaesth 2020;125:e318-e319.
  7. Wee LEI, Conceicao EP, Tan JY, et al. Unintended consequences of infection prevention and control measures during COVID-19 pandemic. Am J Infect Control 2021;49:469-477.
  8. Cerulli Irelli E, Orlando B, Cocchi E, et al. The potential impact of enhanced hygienic measures during the COVID-19 outbreak on hospital-acquired infections: a pragmatic study in neurological units. J Neurol Sci 2020;418:117111.
  9. Baccolini V, Migliara G, Isonne C, et al. The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study. Antimicrob Resist Infect Control 2021;10:87.
  10. Eyre TA, Peters L, Andersson MI, Peniket A, Eyre DW. Reduction in incidence of non-COVID-19 respiratory virus infection amongst haematology inpatients following UK social distancing measures. Br J Haematol 2021;195:194-197.
  11. Yoo IY, Shin DP, Heo W, Ha SI, Cha YJ, Park YJ. Comparison of BD MAX Check-Points CPO assay with Cepheid Xpert Carba-R assay for the detection of carbapenemase-producing Enterobacteriaceae directly from rectal swabs. Diagn Microbiol Infect Dis 2022;103:115716.
  12. Korea Disease Control and Prevention Agency. Case definitions for national notifiable infectious diseases [Internet]. Cheongju: Korea Disease Control and Prevention Agency, 2023 [cited 2023 Sep 1]. Availble from: https://npt.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do?icdCd=ND0501.
  13. Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol 2013;108:478-498; quiz 499.
  14. Korea Disease Control and Prevention Agency. Infectious diseases hompage [Internet]. Cheongju: Korea Disease Control and Prevention Agency, 2021 [cited 2023 Sep 1]. Availble from: https://npt.kdca.go.kr/pot/is/inftnsds.do.
  15. Farfour E, Lecuru M, Dortet L, et al. Carbapenemase-producing Enterobacterales outbreak: another dark side of COVID-19. Am J Infect Control 2020;48:1533-1536.
  16. Thomas GR, Corso A, Pasteran F, et al. Increased detection of carbapenemase-producing Enterobacterales bacteria in Latin America and the Caribbean during the COVID-19 pandemic. Emerg Infect Dis 2022;28:1-8.
  17. Gomez-Simmonds A, Annavajhala MK, McConville TH, et al. Carbapenemase-producing Enterobacterales causing secondary infections during the COVID-19 crisis at a New York City hospital. J Antimicrob Chemother 2021;76:380-384.
  18. Park SY, Cheong HS, Kwon KT, et al. Guidelines for infection control and burnout prevention in healthcare workers responding to COVID-19. Infect Chemother 2023;55:150-165.
  19. Malik SS, Mundra S. Increasing consumption of antibiotics during the COVID-19 pandemic: implications for patient health and emerging anti-microbial resistance. Antibiotics (Basel) 2022;12:45.
  20. Jeon K, Jeong S, Lee N, et al. Impact of COVID-19 on antimicrobial consumption and spread of multidrug-resistance in bacterial infections. Antibiotics (Basel) 2022;11:535.
  21. Meschiari M, Onorato L, Bacca E, et al. Long-term impact of the COVID-19 pandemic on in-hospital antibiotic consumption and antibiotic resistance: a time series analysis (2015-2021). Antibiotics (Basel) 2022;11:826.
  22. Fukushige M, Ngo NH, Lukmanto D, Fukuda S, Ohneda O. Effect of the COVID-19 pandemic on antibiotic consumption: a systematic review comparing 2019 and 2020 data. Front Public Health 2022;10:946077.
  23. Weiner-Lastinger LM, Pattabiraman V, Konnor RY, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2022;43:12-25.
  24. Spigaglia P. Clostridioides difficile infection (CDI) during the COVID-19 pandemic. Anaerobe 2022;74:102518.
  25. Jeon YD, Ann HW, Lee WJ, et al. Characteristics of faecal microbiota in Korean patients with clostridioides difficile-associated diarrhea. Infect Chemother 2019;51:365-375.
  26. Kim MC, Kweon OJ, Lim YK, Choi SH, Chung JW, Lee MK. Impact of social distancing on the spread of common respiratory viruses during the coronavirus disease outbreak. PLoS One 2021;16:e0252963.
  27. Lee H, Lee H, Song KH, et al. Impact of public health interventions on seasonal influenza activity during the COVID-19 outbreak in Korea. Clin Infect Dis 2021;73:e132-e140.
  28. Noh JY, Seong H, Yoon JG, Song JY, Cheong HJ, Kim WJ. Social distancing against COVID-19: implication for the control of influenza. J Korean Med Sci 2020;35:e182.
  29. Suess T, Remschmidt C, Schink SB, et al. The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011. BMC Infect Dis 2012;12:26.
  30. Korea Disease Control and Prevention Agency. Weekly Sentinel Surveillance Report. 2023, 16th week (16 April-22 April). [Internet]. Cheongju: Korea Disease Control and Prevention Agency, 2021 [cited 2023 Sep 1]. Availble from: https://npt.kdca.go.kr/pot/is/st/ari.do.