2020 Healthcare-Associated Infections in the Long-Term Care Setting: An Analysis of Reports from Pennsylvania

Abstract

The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States. In addition to over 3.9 million acute care records, PA-PSRS has collected more than 357,000 long-term care (LTC) healthcare-associated infection reports since 2009. A total of 26,331 infections were reported in 2020, representing a 7.0% decrease from the prior year. The Northeast region of the state had the highest overall infection rate, with 1.29 reports per 1,000 resident days, and the Southeast region had the largest increase in infection rate from the prior year (increased from 0.87 to 1.02). There was a 10.2% increase in respiratory tract infections from 2019 to 2020; however, the other four main infection types decreased (gastrointestinal by 44.6%, device-related bloodstream by 17.0%, skin and soft tissue by 16.5%, and urinary tract by 1.8%). Additionally, of the four infection subtypes that comprise the respiratory tract infections category, all increased from 2019 to 2020 except for pneumonia. The most frequently reported infection subtype in 2020 was cellulitis, soft tissue, or wound infection, although it had the second largest decrease from 2019. The infection rate for catheter-associated urinary tract infections (CAUTI) had the largest increase from 2019 to 2020, and the rate for norovirus had the largest decrease from 2019 to 2020. Infection rates also differed across the various nursing unit types. The seasonal peak for respiratory infections in 2020 occurred in the second quarter, with the exception of influenza, which peaked in the first quarter. Overall, this analysis demonstrates areas in which continued education and infection prevention measures can be applied to further enhance the safety for residents in long-term care facilities.