Active Surveillance and Contact Precautions for Preventing Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections During the COVID-19 Pandemic.

Background: Statistically significant decreases in methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAIs) occurred in Veterans Affairs (VA) hospitals from 2007 to 2019 using a national policy of active surveillance (AS) for facility admissions and contact precautions for MRSA colonized (CPC) or infected (CPI) patients, but the impact of suspending these measures to free up laboratory resources for testing and conserve personal protective equipment for coronavirus disease 2019 (COVID-19) on MRSA HAI rates is not known.

Methods: From July 2020 to June 2022 all 123 acute care VA hospitals nationwide were given the rolling option to suspend (or re-initiate) any combination of AS, CPC, or CPI each month, and MRSA HAIs in intensive care units (ICUs) and non-ICUs were tracked.

Results: There were 917 591 admissions, 5 225 174 patient-days, and 568 MRSA HAIs.

Lack of correlation between standardized antimicrobial administration ratios (SAARs) and healthcare-facility-onset infection rates in Veterans Affairs medical facilities.

We detected no correlation between standardized antimicrobial administration ratios (SAARs) and healthcare facility-onset infection (HO-CDI) rates in 102 acute-care Veterans Affairs medical centers over 16 months. SAARs may be useful for investigating trends in local antimicrobial use, but no ratio threshold demarcated HO-CDI risk.

Healthcare-associated infections in Veterans Affairs acute-care and long-term healthcare facilities during the coronavirus disease 2019 (COVID-19) pandemic.

Objective: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infections (HAIs) reported from 128 acute-care and 132 long-term care Veterans Affairs (VA) facilities.

Methods: We compared central-line-associated bloodstream infections (CLABSIs), ventilator-associated events (VAEs), catheter-associated urinary tract infections (CAUTIs), methicillin-resistant (MRSA), and infections and rates reported from each facility monthly to a centralized database before the pandemic (February 2019 through January 2020) and during the pandemic (July 2020 through June 2021).

Results: Nationwide VA COVID-19 admissions peaked in January 2021.

Hospital coronavirus disease 2019 (COVID-19) public health reporting: Lessons from validation of an automated surveillance tool to facilitate data collection.

A comparison of computer-extracted and facility-reported counts of hospitalized coronavirus disease 2019 (COVID-19) patients for public health reporting at 36 hospitals revealed 42% of days with matching counts between the data sources. Miscategorization of suspect cases was a primary driver of discordance. Clear reporting definitions and data validation facilitate emerging disease surveillance.

Association between infection testing results and decision to treat.

We sought to determine how often patients with a negative toxin enzyme immunoassay following a positive nucleic acid amplification test for infection (CDI) were treated for CDI in Veterans Affairs facilities. From October 2018 through March 2021, 702 (29.5%) of 2,374 unique patients with these test results were treated.

Effect of testing methods on incidence of infection rates in Veterans' Affairs medical centers.

Clostridioidesdifficile infection rates from 7 facilities that used nucleic acid amplification testing (NAAT) alone for 12 months then switched to NAAT plus toxin enzyme immunoassay (EIA) and reported the latter result for 12 months were compared to 70 facilities that used NAAT alone for all 24 months. There was no significant difference in rates between facility groups over the first 12 months (P = .21, linear regression), but we detected a decrease in rates for the facilities that changed to NAAT+EIA (P < .

A targeted assessment for prevention strategy to decrease infections in Veterans Affairs acute-care medical centers.

Objective: A guideline for the prevention of Clostridioides difficile infection (CDI) in 127 Veterans Health Administration acute-care facilities was implemented in July 2012. Beginning in 2015, a targeted assessment for prevention strategy was used to evaluate facilities for hospital-onset healthcare-facility-associated CDIs to focus prevention efforts where they might have the most impact in reaching a reduction goal of 30% nationwide.

Methods: We calculated standardized infection ratios (SIRs) and cumulative attributable differences (CADs) using a national data baseline.