A new study suggests hospitals should test all patients for COVID-19 upon admission as an infection control measure to prevent hospital-onset cases when community infection rates are high.
The findings were published Aug. 28 in JAMA Network Open and are based on more than 4.4 million hospitalization records across 288 hospitals during the first two years of the pandemic. Overall, findings showed hospital-onset infection rates for SARS-CoV-2 were similar to those of other healthcare-associated infections, such as urinary tract infections and bloodstream infections. They increased when community-onset infections were higher.
Among 171,564 hospitalizations with a positive COVID-19 test, 4.4 percent were determined to be hospital-onset and 3.8 percent were indeterminate. Most admissions involving a positive test had a positive test on the first day of hospitalization.
Researchers found a connection between admissions testing and lower hospital-onset infection rates. "Our models indicate that hospital-onset SARS-CoV-2 infection rates were lower among hospitals with greater than 50 percent of hospitalizations tested at admission" versus those with fewer than 50 percent tested, the study said.
Taken together, researchers said the findings suggest hospitals should consider admission testing as a strategy to reduce the number of hospital-onset infections, particularly during peak periods of community-level rates.
"Admission testing might serve as an infection control strategy to prevent hospital-onset infections by identifying potentially contagious patients upon arrival," the study said. "Additionally, high rates of admission testing could be a proxy indicator for more intense infection-control programs that include additional interventions to prevent hospital-onset cases, such as better adherence to universal masking, more attention to ventilation, and increased use of respiratory for both healthcare worker protection and source control."