Coronavirus disease 2019 (COVID-19) era hospital infection controls reduce other serious infections and must be continued after the COVID-19 tragedy is resolved

To the Editor—I read with great interest your 3 recent papers by Wong et al¹ Ponce-Alonso et al², and Wee et al,³ who report that coronavirus disease 2019 (COVID-19)–era infection control bundles are associated in significant decreases in many nosocomial viral and bacterial infection rates such as influenza, respiratory syncytial virus, adenovirus, and Clostridium difficile. The Ponce-Alonso Spanish study reported a decrease of 69% in hospital-acquired Clostridium difficile infection rates following implementation of a hospital infection control bundle: incidence density was 8.54 per 10,000 patients day before and 2.68 per 100,000 days after the COVID-19 infection control bundle (P = .000257²).

Other studies have also reported that COVID-19–era infection controls such as hand washing, masking and gowning, better hospital cleaning, and isolation of COVID-19 patients can significantly reduce rates of many bacterial and viral infections. A study in a 1,785-bed Singapore hospital reported that the use of COVID-19–related infection control bundles was associated with significantly reduced rates of many hospital-acquired infections, including nosocomial respiratory infections (incidence rate, 0.08; 95% CI, 0.05–0.13), nosocomial MRSA (IR, 0.54; 95% CI, 0.46–0.64), and central-line bloodstream infections (IR, 0.24; 95% CI, 0.07–0.57).⁴ A California study involving 37,033 hospital patient days reported that following implementation of a COVID-19 infection control bundle, rates of many multidrug-resistant pathogens decreased significantly including a 41% decrease in methicillin-resistant Staphylococcus aureus (MRSA), a 21% decrease in (extended-spectrum β-lactamase bacteria (ESBL), and an 80% decrease in vancomycin-resistant enterococci (VRE).⁵

Better hospital infection control bundles can also reduce rates of common nosocomial fungal infections,⁶ although I am not aware of any current studies that have reported on lower rates of Aspergillus or Candida in the COVID-19 era. Such studies of COVID-19–era nosocomial Aspergillus and Candida rates might yield useful data on how to prevent common life-threatening fungal infections.

Clearly, enhanced infection control procedures need to be followed long after the COVID-19 tragedy has resolved.⁷ I hope that Infection Control and Hospital Epidemiology will continue to publish more good papers on COVID-19–era infection control.