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Healthcare-Associated Infections Annual Report 2021

healthcare-associated infections (hai) program

Making Healthcare Safer for All Californians
Healthcare-Associated Infections in California Hospitals Annual Report, 2021

As the COVID-19 pandemic continued in 2021 with the emergence of more transmissible SARS-CoV-2 variants, some healthcare infection prevention and control (IPC) challenges lessened, while others persisted or worsened. Highly effective vaccines substantially mitigated COVID-19 morbidity and mortality, testing capacity increased, and personal protective equipment supplies improved; however, chronic staffing shortages were exacerbated by surges and burnout, and many routine HAI prevention care practices were not restored. In 2021, California hospitals’ statewide incidence for central line-associated bloodstream infections (CLABSI) and methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA BSI) remained persistently elevated following the substantial increases observed at the onset of the COVID-19 pandemic.

As described in this report, CDPH HAI Program epidemiologists conducted in-depth analyses of CLABSI data to further characterize hospital types and locations with the greatest increases and identify hospitals to engage in a CLABSI reduction initiative. With the support of additional Centers for Disease Control and Prevention (CDC) Epidemiology and Laboratory Capacity (ELC) funding for Strengthening HAI/AR Programs (SHARP) awarded in October 2021, the HAI Program has resumed and expanded our statewide and regional HAI and antimicrobial resistance (AR) prevention initiatives while continuing to provide IPC consultation and support across the continuum of health care as part of the ongoing COVID-19 pandemic response.

CDPH also continues to engage the California HAI Advisory Committee and other hospital partners to identify and support implementation of strategies for maintaining the highest possible quality hospital IPC practices while managing ongoing pandemic- and surge-related challenges. CDPH is also seeking advice from the HAI Advisory Committee about re-establishing short and long-term goals for HAI and AR prevention in California hospitals. Ultimately our goal is to leverage lessons learned during the pandemic to advocate for resources and improve IPC program resiliency to future stressors, and eventually achieve even greater and more sustained HAI/AR prevention outcomes.