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S102 • OFID 2021:8 (Suppl 1) • Abstracts
and outreach; sending regional outbreak HCF lists to all HCF; and biweekly state-LHJ
coordination calls. e Antibiotic Resistance (AR) Lab Network supported testing.
Results. From May 2020—May 2021, we conducted screening at 226 HCF,
and identied 1192 cases at 93 HCF, mostly through screening (n=1109, 93%) and
at LTACH (n=906, 76%); we identied 113 (10%) cases at ACH, including 35 (31%)
in COVID-19-burdened units. Cases peaked in August 2020 (n=93) and February
2021 (n=191) and have since declined, with C.auris resurgence mirroring COVID-19
incidence.
We conducted 98 onsite IPC assessments, and identied multiple, improper IPC
practices which had been implemented in response to COVID-19, including dou-
ble-gloving and -gowning, extended use of gowns and gloves outside patient rooms,
and cohorting according to COVID-19 statusonly.
Figure 1. C. auris and COVID-19 Cases in California through May 2021, and
C.auris Cases by Local Health Jurisdiction (LHJ) May 2020–May2021
Table 1.By Facility Type: Colonization Testing May 2020–May 2021, and Total Case
Counts before and from May2020
Table 2.COVID-19-related Infection Control Practices Aecting C.auris Spread, and
Associated Public Health Recommendations
Conclusion. e C. auris resurgence in CA was likely a result of COVID-19-
related practices and conditions. An aggressive, coordinated, interjurisdictional
C.auris containment response, including proactive prevention activities at HCF inter-
connected with outbreak HCF, can help mitigate spread of C.auris and potentially
other novel AR pathogens.
Disclosures. Al l Authors: No reported disclosures
170. Reduction in Bloodborne Pathogen Splash Exposures After Implementation
of Universal Masking and Eye Protection for COVID-19
MarciDrees, MD, MS1; TabeMase, MSN, ARNP, COHN-S2; JenniferGarvin, MBA1;
KimberlyMiller, MSN, RN, CMLSO1; 1ChristianaCare, Newark, DE; 2Christiana Care
Health System, Newark, DE
Session: O-34. The Interplay Between COVID and other Infections
Background. While splashes to the eyes, nose and mouth can oen be prevented
through appropriate personal protective equipment (PPE) use, they continue to occur
frequently when PPE is not used consistently. Due to the COVID-19 pandemic, we
implemented universal masking and eye protection for all healthcare personnel (HCP)
performing direct patient care and observed a subsequent decline in bloodborne
pathogen (BBP) splash exposures.
Methods. Our healthcare system, employing >12,000 healthcare personnel
(HCP), implemented universal masking in April 2020 and eye protection in June 2020.
We required HCP to mask at all times, and use a face shield, safety glasses or goggles
when providing direct patient care. Occupational Safety tracked all BBP exposures
due to splashes to the eyes, nose, mouth and/or face, and compared exposures during
2020 to those in 2019. We estimated costs, including patient and HCP testing, related
to splash exposures, as well as the additional cost of PPE incurred.
Results. In 2019, HCP reported 90 splashes, of which 57 (63%) were to the eyes.
In 2020, splashes decreased by 54% to 47 (36 [77%] to eyes). In both years, nurses were
the most commonly aected HCP type (62% and 72%, respectively, of all exposures).
Physicians (including residents) had the greatest decrease in 2020 (10 vs. 1 splash expo-
sures [90%]), while nurses had a 39% decrease (56 vs. 34 exposures). Nearly all of the
most common scenarios leading to splash exposures declined in 2020 (Table). We esti-
mated the cost of each BBP exposure as $2,940; this equates to a savings of $123,228.
During 2020, we purchased 65,650 face shields, safety glasses and goggles (compared
to 5303 similar items in 2019), for an additional cost of $238,440.
Specic activities identied as leading to bloodborne pathogen splash exposures,
2019 vs.2020.
Conclusion. We observed a signicant decline in splash-related BBP exposures
aer implementing universal masking and eye protection for the COVID-19 pan-
demic. While cost savings were not observed, we were unable to incorporate the
avoided pain and emotional trauma for the patient, exposed HCP, and coworkers. is
unintended but positive consequence of the COVID-19 pandemic exemplies the need
for broader use of PPE, particularly masks and eyewear, for all patient care scenarios
where splashes may occur.
Disclosures. Al l Authors: No reported disclosures
171. The Impact of COVID-19 on Healthcare-Associated Infections
MeghanA.Baker, MD, ScD1; KennethSands, MD, MPH2;
SusanS.Huang , MD, MPH3; KenKleinman, PhD4; EdwardSeptimus, MD5;
NehaVa rma , MPH5; EuniceJ.Blanchard, MSN RN2; RussellPolan d, PhD2;
MicaelaH.Coady, MS6; DeborahS.Yok o e , MD, MPH7; DeborahS.Yo k o e, MD,
MPH7; SarahFraker, MS, CHDA2; AllisonFroman, MPH6; JuliaMoody, MS2;
LaurelGoldin, MA2; AmandaIsaacs, MSPH6; KacieKleja, MS2;
KimberlyKorwek, PhD2; JohnStelling, MD, MPH8; AdamClark, BS8;
RichardPlatt, MD, MSc5; JonathanB.Perlin, MD, PhD2; 1Harvard Medical School/
Harvard Pilgrim Health Care Institute and Brigham and Women’s Hospital, Boston,
Massachusetts; 2HCA Healthcare, Nashville, TN; 3University of California, Irvine,
Irvine, CA; 4University of Massachusetts, Amherst, Massachusetts; 5Harvard
Medical School, Houston, Texas; 6Harvard Pilgrim Health Care Institute, boston,
Massachusetts; 7University of California, San Francisco, San Francisco, CA; 8Brigham
and Women’s Hospital, Boston, Massachusetts
For the CDC Prevention Epicenters Program
Session: O-34. The Interplay Between COVID and other Infections
Background. e profound changes wrought by COVID-19 on routine hospital
operations may have inuenced performance on hospital measures, including health-
care-associated infections (HAIs).
Objective. Evaluate the association between COVID-19 surges and HAI or
cluster rates
Methods. Design: Prospective cohort study
Setting. 148 HCA Healthcare-aliated hospitals, 3/1/2020-9/30/2020, and a
subset of hospitals with microbiology and cluster data through 12/31/2020
Patients. All inpatients
Measurements. We evaluated the association between COVID-19 surges and
HAIs, hospital-onset pathogens, and cluster rates using negative binomial mixed mod-
els. To account for local variation in COVID-19 pandemic surge timing, we included
the number of discharges with a laboratory-conrmed COVID-19 diagnosis per
staed bed per month at each hospital.
Results. Central line-associated blood stream infections (CLABSI), catheter-as-
sociated urinary tract infections (CAUTI), and methicillin-resistant Staphylococcus
aureus (MRSA) bacteremia increased as COVID-19 burden increased (P ≤ 0.001
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