In 2020, COVID-19 stamped out years of steady decline in healthcare-associated infections, spurring significant increases in four of six routinely tracked infections, according to an analysis by the Centers For Disease Control and Prevention (CDC).

The increases have been blamed on larger numbers of sicker patients and more frequent and extended use of ventilators and catheters, Healthcare Hygiene Magazine reports. Staffing and supply challenges compounded the problem, according to the analysis.

“COVID-19 created a perfect storm for antibiotic resistance and healthcare-associated infections in healthcare settings,” Dr. Arjun Srinivasan, CDC’s associate director of healthcare-associated infection prevention programs, tells Healthcare Hygiene. “Prior to the pandemic, public health — in partnership with hospitals — successfully drove down these infections for several years across U.S. hospitals.”

The four infection types most impacted were central-line associated bloodstream infections; ventilator-associated infections; catheter-associated urinary tract infections; and antibiotic resistant staph infections. That’s according to CDC analysts Lindsey M. Weiner-Lastinger and others published in Infection Control & Hospital Epidemiology.

Dramatic increases in the use of ventilators prompted a 45 percent increase in ventilator-associated infections in the fourth quarter of 2020 compared with 2019.

“Infection control practices in COVID-19 wards often adapted to shortages of personal protective equipment, responded to fear of healthcare personnel, and did not always lend themselves to better infection prevention,” write Dr. Tara N. Palmore and Dr. David K. Henderson of the National Institutes of Health in an editorial that accompanied the study.

At the same time, two other infections remained steady or declined during the same time period, despite the pandemic. There was no increase in surgical site infections as fewer elective surgeries were performed. Clostridioides Difficile, known as C. diff, also did not see an increase.

Improved hand hygiene, cleaning, extensive use of PPE, and more patient isolation likely contributed to the flat rate, according to the study.

Another infection-prevention tool amid the pandemic: single-use endoscopes. In June, the U.S. Food & Drug Administration, for the first time, recommended that healthcare providers consider single-use bronchoscopes when there is increased risk of spreading infection and when treating COVID-19 patients.

The new FDA communication also recommends healthcare facilities use sterilization, rather than high-level disinfection, when possible for flexible bronchoscopes. If there is “no support for immediate reprocessing,” providers should use single-use bronchoscopes.

That FDA action came as the country continues to battle the global pandemic which has put the spotlight on healthcare worker safety and the risks of hospital-acquired infections.