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While New Jersey's health care system confronts a growing influx of patients requiring treatment for COVID-19, the Centers for Disease Control and Prevention (CDC) released a new report that details potential risks of non-coronavirus infection transmission in certain hospital settings.
The report, published Tuesday, offered findings collected during an investigation into one New Jersey medical facility's outbreak of Carbapenem-resistant Acinetobacter baumannii (CRAB), a bacterial infection that does not respond to drug treatments and is commonly transmitted among hospital patients, earlier this year.
As the CDC noted prominently in its report, the drug-resistant infection outbreak occurred as New Jersey's health system confronted an initial surge in COVID-19 patients last spring. The hospital, which itself saw a surge in COVID-19 patients during the first several months of the pandemic, coordinated with the New Jersey Department of Health (NJDOH) to lead the investigation. The CDC later conducted a review of the state health department's assessment.
The hospital is described as an acute-care facility with roughly 500 beds. The environment alone posed heightened risks for increased CRAB transmission, given that the "hospital-acquired" infection—as the CDC referred to it—spreads most easily through critical care sites. According to the health agency, this hospital reported an outbreak of CRAB cases to the NJDOH during the final week of May. Its subsequent investigation identified 34 confirmed instances of the infection in patients admitted to the hospital between February and July.
Of all patients who contracted the infection over the five-month period, more than 80 percent were affected amid the hospital's spike in COVID-19 cases. Half of CRAB-infected patients also tested positive for COVID-19, and slightly more than 40 percent developed CRAB ventilator-associated pneumonia. Most of the patients identified with CRAB infections required intubation and mechanical ventilation.
The CDC acknowledged that a surge in COVID-19 patients admitted to the New Jersey hospital between March and June stretched the facility's resources, and described observable changes to its usual protocols related to infection prevention and control, or IPC. These changes included less frequent ventilator and catheter replacements for patients, as well as extended periods of personal protective equipment use for medical professionals.
"The facility experienced critical shortages in personnel for nursing and environmental services, resulting from staff members' illness, quarantine, and a surge in the number of patients with COVID-19," the CDC wrote in Tuesday's report.
As a result, fewer staff members became responsible for larger patient groups. Coupled with elevated efforts to reduce staff's contact with patients in light of the virus outbreak, this "might have led to unidentified IPC breaches," the report added, while noting that the hospital was just one of many forced to adapt when the pandemic first began to overwhelm health care institutions.
"This outbreak highlights that MDROs [multidrug-resistant organisms] can spread rapidly in hospitals experiencing surges in COVID-19 cases and cause serious infections in this setting," the CDC concluded in its report. "Facilities should prioritize continuity of core IPC practices (e.g., training for and auditing of hand hygiene, PPE use, and environmental cleaning) to the greatest extent possible during surges in hospitalizations and make every effort to return to normal operating procedures as soon as capacity allows."
Newsweek reached out to the CDC and New Jersey Department of Health for comments but did not receive replies in time for publication.
