Impact of infection prevention and control precautions taken during COVID-19 pandemic on healthcare associated infections (HAIS)

Introduction: From the start of the COVID-19 pandemic, heightened awareness and diligent efforts are made to ensure zero healthcareassociated COVID-19 amongst healthcare workers. Hand hygiene, environment hygiene and use of appropriate personal protective equipment (PPE) are emphasized and daily audits are done to ensure compliance. Objectives: We are interested to know if these enhanced measures help towards reducing healthcare associated infections (HAIs) amongst inpatients at the Singapore General Hospital, a 1750-bedded acute tertiary care hospital. Methods: We compared standardized infection ratios (SIRs) of healthcare- onset (HO)-MRSA bacteremia, HO-Clostridium difficile, CLABSI and CAUTI rates pre-COVID (Nov 2017-Dec 2019) and during COVID- 19 pandemic (Mar-Sep 2020). SIRs were computed following NHSN methodology. Results: SIR values were less than 1 for HO-MRSA bacteremia, HOClostridium difficile, CLABSI during the peak of COVID-19 pandemic, Mar-Sep 2020 (0.38, 0.44 and 0.31 respectively). Control charts plotted from Nov 2017 confirmed that there was a shift in data points for CLABSI from Sep 2019 - Oct 2020. However, there was no significant impact on the other 3 indicators. Our institution has zero healthcare associated COVID-19 amongst staff to date. Conclusion: The enhanced IPC precautions instituted during COVID- 19 pandemic succeeded in sustaining decreased CLABSI rates likely because of increased compliance to CLABSI bundle. We have demonstrated that enhanced infection prevention and control horizontal measures viz. hand hygiene, environment hygiene help towards keeping HAIs low in our hospital. These should continue post-pandemic as they are part of Standard Precautions.