Effects of COVID-19 hospitalization rates on the incidence of hospital-acquired Candida central line-associated bloodstream infection

Background: An increase in central line-associated bloodstream infections (CLABSIs) has been reported during the Coronavirus (COVID-19) pandemic; however, few studies have documented causative pathogens, particularly Candida species associated with candidemia. Methods: This was a retrospective study based on the National Health Care Safety Network surveillance definitions of CLABSI caused by Candida species during pre-COVID-19 (October 2017 to February 2020) and COVID-19 (March 2020 to December 2021) periods within a local community hospital. Candida CLABSI incidence per 1,000 central line days was compared between periods using the χ² test and correlated with COVID-19 inpatient hospitalization rates using Pearson correlation. Results: Overall CLABSI (0.68 vs 1.98 per 1,000, P = .004) and Candida CLABSI incidence (0.06 vs 0.77 per 1,000, P = .003) significantly increased from pre-COVID-19 to COVID-19 periods. There was a significant correlation between COVID-19 ICU hospitalizations and CLABSIs (R = 0.18, P = .048), but not acute care hospitalizations and CLABSIs (R = 0.065, P = .250). Conversely, there was a significant association between COVID-19 acute care hospitalizations and Candida CLABSIs (R = 0.50, P < .001), but not COVID-19 ICU hospitalizations and Candida CLABSIs (R = 0.01, P = .631). Conclusions: During the COVID-19 pandemic, our facility experienced a significant increase in Candida CLABSI and a significant correlation of Candida CLABSIs with acute care COVID-19 hospitalizations.