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Ai L, Fang L, Zhou C, Liu B, Yang Q, Gong F. The impact of the COVID-19 pandemic on Staphylococcus aureus infections in pediatric patients admitted with community acquired pneumonia. Sci Rep 2024; 14:15737. [PMID: 38977804 PMCID: PMC11231152 DOI: 10.1038/s41598-024-66071-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024] Open
Abstract
The COVID-19 pandemic has significantly transformed the infection spectrum of various pathogens. This study aimed to evaluate the impact of the COVID-19 pandemic on Staphylococcus aureus (S. aureus) infections among pediatric patients with community acquired pneumonia (CAP). We retrospectively reviewed pediatric CAP admissions before (from 2018 to 2019) and during (from 2020 to 2022) the COVID-19 pandemic. The epidemiology and antimicrobial resistance (AMR) profiles of S. aureus isolates were examined to assess the pandemic's effect. As a result, a total of 399 pediatric CAP patients with S. aureus infections were included. The positivity rate, gender, and age distribution of patients were similar across both periods. There was a marked reduction in respiratory co-infections with Haemophilus influenzae (H. influenzae) during the COVID-19 pandemic, compared to 2019. Additionally, there were significant changes in the resistance profiles of S. aureus isolates to various antibiotics. Resistance to oxacillin and tetracycline increased, whereas resistance to penicillin, gentamicin, and quinolones decreased. Notably, resistance to erythromycin significantly decreased in methicillin-resistant S. aureus (MRSA) strains. The number of S. aureus isolates, the proportion of viral co-infections, and the number of resistant strains typically peaked seasonally, primarily in the first or fourth quarters of 2018, 2019, and 2021. However, shifts in these patterns were noted in the first quarter of 2020 and the fourth quarter of 2022. These findings reveal that the COVID-19 pandemic has significantly altered the infection dynamics of S. aureus among pediatric CAP patients, as evidenced by changes in respiratory co-infections, AMR patterns, and seasonal trends.
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Affiliation(s)
- Ling Ai
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Liang Fang
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Chanjuan Zhou
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Beizhong Liu
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education,, Department of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Quan Yang
- Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Fang Gong
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China.
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
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2
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Russotto A, Vicentini C, Ferrigno L, Crateri S, Russo R, Tosti ME, Zotti CM. Impact of the COVID-19 pandemic on the Italian national viral hepatitis surveillance: an interrupted time series analysis, 2006-2022. Public Health 2024; 232:14-20. [PMID: 38728904 DOI: 10.1016/j.puhe.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/03/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES This study aimed to assess the impact of the COVID-19 pandemic on national surveillance of viral hepatitis in Italy. STUDY DESIGN Interrupted time series analysis. METHODS Using an interrupted time series analysis with a customised AutoRegressive Integrated Moving Average model on hepatitis cases reported to the Integrated Epidemiological System of Acute Viral Hepatitis from 2006 to 2022, we examined trends in incidence, time to diagnosis and time to epidemiological investigations for hepatitis A, hepatitis B and hepatitis C. RESULTS The quarterly incidence of hepatitis B (-0.251, P = 0.05) and hepatitis C (-0.243, P = 0.003) significantly decreased with the onset of the pandemic. Surveillance times for hepatitis B (5.496, P < 0.001) and hepatitis C (35.723, P < 0.001), measured as days lost per quarter, significantly increased 12 and 24 months after the pandemic's start. This aligns with a notable rise in quarterly incidence at 36 months for both (0.032, P = 0.030 for hepatitis B; 0.040, P < 0.001 for hepatitis C). CONCLUSIONS The decrease in reported cases could be due to an increase in infection prevention control and containment measures put in place in a pandemic context. However, a delay in the initiation of epidemiological investigations was observed, which could lead to a further increase in incidence in the future.
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Affiliation(s)
- A Russotto
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy.
| | - C Vicentini
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - L Ferrigno
- National Center for Global Health - Istituto Superiore di Sanità (ISS), Rome, Italy
| | - S Crateri
- National Center for Global Health - Istituto Superiore di Sanità (ISS), Rome, Italy
| | - R Russo
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - M E Tosti
- National Center for Global Health - Istituto Superiore di Sanità (ISS), Rome, Italy
| | - C M Zotti
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
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3
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Iftimie S, López-Azcona AF, Corchero-Valverde M, Peralta-Vázquez A, López-Cordón LR, García-Cervera C, Fernández-Domínguez LM, Camps J, Joven J, Castro A. Retrospective Analysis of Clostridioides difficile Infection Rates and Outcomes in Hospitalized Patients during the COVID-19 Pandemic: A Unicenter Study in Reus, Spain. J Clin Med 2024; 13:2799. [PMID: 38792341 PMCID: PMC11122305 DOI: 10.3390/jcm13102799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Background:Clostridioides difficile infections (CDI) vary in severity from mild diarrhea to life-threatening conditions like pseudomembranous colitis or toxic megacolon, often leading to sepsis and death. The COVID-19 pandemic prompted changes in healthcare practices, potentially affecting CDI incidence, though reported data are inconclusive. We studied factors influencing CDI incidence and outcomes at a university hospital throughout the COVID-19 pandemic years. Methods: We conducted a retrospective study on all adult hospitalized CDI cases from 1 January 2020 to 31 December 2022 in Hospital Universitari de Sant Joan in Reus. We collected demographic information, comorbid conditions, and concurrent infections. Results: While overall CDI and COVID-19 rates decreased in 2022, a notable increase in CDI infections was observed among oncological patients and those undergoing some aggressive treatments, such as colonoscopies or gastroscopies. The prevalence of comorbidities remained unmodified, and there were declines in prior gastrointestinal surgeries and proton pump inhibitor prescriptions. Factors associated with patient fatality or prolonged hospitalization included older age, cancer, chronic kidney disease, higher Charlson and McCabe indices, elevated C-reactive protein, and low albumin concentrations. Conclusions: Our study shows the evolving landscape of CDI during the COVID-19 pandemic and emphasizes the impact of delayed diagnoses and treatments exacerbated by telemedicine adoption. Identified risk factors for CDI-related mortality or prolonged hospital stays underscore the importance of targeted interventions in high-risk populations.
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Affiliation(s)
- Simona Iftimie
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | - Ana F. López-Azcona
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | - Mireia Corchero-Valverde
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | - Antonio Peralta-Vázquez
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | - Laia Revuelta López-Cordón
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | - Carles García-Cervera
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
| | | | - Jordi Camps
- Unitat de Recerca Biomèdica, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain;
| | - Jorge Joven
- Unitat de Recerca Biomèdica, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain;
| | - Antoni Castro
- Department of Internal Medicine, Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain; (S.I.); (A.F.L.-A.); (M.C.-V.); (A.P.-V.); (L.R.L.-C.); (C.G.-C.); (A.C.)
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Oh S, Sung YS, Jang M, Kim YJ, Park HW, Nho D, Lee DG, Yim HW, Cho SY. Impact of the coronavirus disease 2019 pandemic on the incidence of other infectious diseases in the hematology hospital in Korea. Korean J Intern Med 2024; 39:513-523. [PMID: 38649159 PMCID: PMC11076895 DOI: 10.3904/kjim.2023.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND/AIMS Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units. METHODS This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic. RESULTS The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively). CONCLUSION The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.
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Affiliation(s)
- Seohee Oh
- Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Yu-Sun Sung
- Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Mihee Jang
- Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Yong-Jin Kim
- Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hyun-Wook Park
- Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Dukhee Nho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Dong-Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Sung-Yeon Cho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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5
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Mimura T, Matsumoto G, Natori T, Ikegami S, Uehara M, Oba H, Hatakenaka T, Kamanaka T, Miyaoka Y, Kurogochi D, Fukuzawa T, Koseki M, Kanai S, Takahashi J. Impact of the COVID-19 pandemic on the incidence of surgical site infection after orthopaedic surgery: an interrupted time series analysis of the nationwide surveillance database in Japan. J Hosp Infect 2024; 146:160-165. [PMID: 37301228 PMCID: PMC10250054 DOI: 10.1016/j.jhin.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, hygiene awareness was increased in communities and hospitals. However, there is controversy regarding whether such circumstances affected the incidence of surgical site infections (SSIs) in the orthopaedic surgical field. AIM To examine the impact of the COVID-19 pandemic on the incidence of SSIs after orthopaedic surgery. METHODS The medical records of patients having undergone orthopaedic surgery were extracted from the nationwide surveillance database in Japan. The primary outcomes were the monthly incidences of total SSIs, deep or organ/space SSIs, and SSIs due to meticillin-resistant Staphylococcus aureus (MRSA). Interrupted time series analysis was conducted between pre-pandemic (January 2017 to March 2020) and pandemic (April 2020 to June 2021) periods. RESULTS A total of 309,341 operations were included. Interrupted time series analysis adjusted for seasonality showed no significant changes in the incidence of total SSIs (rate ratio 0.94 and 95% confidence interval 0.98-1.02), deep or organ/space SSIs (0.91, 0.72-1.15), or SSIs due to MRSA (1.07, 0.68-1.68) along with no remarkable slope changes in any parameter (1.00, 0.98-1.02; 1.00, 0.97-1.02; and 0.98, 0.93-1.03, respectively). CONCLUSIONS Awareness and measures against the COVID-19 pandemic did not markedly influence the incidence of total SSIs, deep or organ/space SSIs, or SSIs due to MRSA following orthopaedic surgery in Japan.
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Affiliation(s)
- T Mimura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
| | - G Matsumoto
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Natori
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Division of Infection Control, Shinshu University Hospital, Matsumoto, Japan
| | - S Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Uehara
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - H Oba
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Hatakenaka
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Kamanaka
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Y Miyaoka
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - D Kurogochi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Fukuzawa
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Koseki
- Faculty of Textile Science and Technology, Shinshu University, Nagano, Japan
| | - S Kanai
- Division of Infection Control, Shinshu University Hospital, Matsumoto, Japan
| | - J Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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6
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Guerrero-Soler M, Gras-Valentí P, Gómez-Sotero IL, Platas-Abenza G, Silva-Afonso RDF, Benito-Miralles CM, Fuster-Pérez M, Cartagena-Llopis L, Sánchez-Valero M, Sánchez-Payá J, Chico-Sánchez P. Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated cross-sectional study. Epidemiol Infect 2024; 152:e69. [PMID: 38557427 PMCID: PMC11077604 DOI: 10.1017/s0950268824000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.
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Affiliation(s)
- Maria Guerrero-Soler
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Paula Gras-Valentí
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Isel Lilibeth Gómez-Sotero
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Guillermo Platas-Abenza
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Raissa de Fátima Silva-Afonso
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Carmen-María Benito-Miralles
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Marina Fuster-Pérez
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Lidia Cartagena-Llopis
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - María Sánchez-Valero
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pablo Chico-Sánchez
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
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7
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Mrvič T, Stevanoska S, Beović B, Logar M, Gregorčič S, Žnidaršič B, Seme K, Velimirović I, Švent Kučina N, Maver Vodičar P, Križan Hergouth V, Džeroski S, Pirs M. The Impact of COVID-19 on Multidrug-Resistant Bacteria at a Slovenian Tertiary Medical Center. Antibiotics (Basel) 2024; 13:214. [PMID: 38534649 DOI: 10.3390/antibiotics13030214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/18/2024] [Indexed: 03/28/2024] Open
Abstract
The COVID-19 pandemic has strained healthcare systems globally. Shortages of hospital beds, reassignment of healthcare workers to COVID-19-dedicated wards, an increased workload, and evolving infection prevention and control measures have potentially contributed to the spread of multidrug-resistant bacteria (MDRB). To determine the impact of the COVID-19 pandemic at the University Medical Center Ljubljana, a tertiary teaching hospital, we analyzed the monthly incidence of select bacterial species per patient from 2018 to 2022. The analysis was performed for all isolates and for MDRB isolates. The data were analyzed separately for isolates from all clinical samples, from blood culture only, and from clinical and surveillance samples. Our findings revealed an increased incidence density of patients with Enterococcus faecium, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa isolates from clinical samples during the COVID-19 period in the studied hospital. Notably, the incidence density of MDRB isolates-vancomycin-resistant E. faecium, extended-spectrum betalactamase-producing K. pneumoniae, and betalactam-resistant P. aeruginosa-from clinical samples increased during the COVID-19 period. There were no statistically significant differences in the incidence density of patients with blood culture MDRB isolates. We observed an increase in the overall MDRB burden (patients with MDRB isolates from both clinical and surveillance samples per 1000 patient days) in the COVID-19 period in the studied hospital for vancomycin-resistant E. faecium, carbapenem-resistant K. pneumoniae, and betalactam-resistant P. aeruginosa and a decrease in the methicillin-resistant S. aureus burden.
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Affiliation(s)
- Tatjana Mrvič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Bojana Beović
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Mateja Logar
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Sergeja Gregorčič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Benica Žnidaršič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Ivana Velimirović
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Nataša Švent Kučina
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Polona Maver Vodičar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Veronika Križan Hergouth
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Mateja Pirs
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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8
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Chen N, Li S, Kuang Z, Gong T, Zhou W, Wang Y. Identifying a competency improvement strategy for infection prevention and control professionals: A rapid systematic review and cluster analysis. HEALTH CARE SCIENCE 2024; 3:53-66. [PMID: 38939168 PMCID: PMC11080890 DOI: 10.1002/hcs2.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 06/29/2024]
Abstract
Remarkable progress has been made in infection prevention and control (IPC) in many countries, but some gaps emerged in the context of the coronavirus disease 2019 (COVID-19) pandemic. Core capabilities such as standard clinical precautions and tracing the source of infection were the focus of IPC in medical institutions during the pandemic. Therefore, the core competences of IPC professionals during the pandemic, and how these contributed to successful prevention and control of the epidemic, should be studied. To investigate, using a systematic review and cluster analysis, fundamental improvements in the competences of infection control and prevention professionals that may be emphasized in light of the COVID-19 pandemic. We searched the PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, and CBM databases for original articles exploring core competencies of IPC professionals during the COVID-19 pandemic (from January 1, 2020 to February 7, 2023). Weiciyun software was used for data extraction and the Donohue formula was followed to distinguish high-frequency technical terms. Cluster analysis was performed using the within-group linkage method and squared Euclidean distance as the metric to determine the priority competencies for development. We identified 46 studies with 29 high-frequency technical terms. The most common term was "infection prevention and control training" (184 times, 17.3%), followed by "hand hygiene" (172 times, 16.2%). "Infection prevention and control in clinical practice" was the most-reported core competency (367 times, 34.5%), followed by "microbiology and surveillance" (292 times, 27.5%). Cluster analysis showed two key areas of competence: Category 1 (program management and leadership, patient safety and occupational health, education and microbiology and surveillance) and Category 2 (IPC in clinical practice). During the COVID-19 pandemic, IPC program management and leadership, microbiology and surveillance, education, patient safety, and occupational health were the most important focus of development and should be given due consideration by IPC professionals.
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Affiliation(s)
- Nuo Chen
- School of Public Health and ManagementHubei University of MedicineShiyanChina
| | - Shunning Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of OptometryTianjin Medical University Eye HospitalTianjinChina
| | - Zhengling Kuang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeTianjin Institutes of Health ScienceTianjinChina
| | - Ting Gong
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical SciencesFudan UniversityShanghaiChina
| | - Weilong Zhou
- Department of Infection Control and Prevention, West China Second University HospitalSichuan UniversityChengduChina
| | - Ying Wang
- Department of Infection Prevention and Control ManagementZhongnan Hospital of Wuhan UniversityWuhanChina
- Hubei Engineering Center for Infectious Disease Prevention, Control and TreatmentWuhanChina
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9
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Rerkasem A, Thaichana P, Bunsermvicha N, Nopparatkailas R, Arwon S, Orrapin S, Reanpang T, Apichartpiyakul P, Orrapin S, Siribumrungwong B, Lumjuan N, Rerkasem K, Derraik JGB. A COVID-19 Silver Lining-Decline in Antibiotic Resistance in Ischemic Leg Ulcers during the Pandemic: A 6-Year Retrospective Study from a Regional Tertiary Hospital (2017-2022). Antibiotics (Basel) 2023; 13:35. [PMID: 38247594 PMCID: PMC10812686 DOI: 10.3390/antibiotics13010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Antibiotic resistance (AR) associated with chronic limb-threatening ischemia (CLTI) poses additional challenges for the management of ischemic leg ulcers, increasing the likelihood of severe outcomes. This study assessed AR prevalence in bacteria isolated from CLTI-associated leg ulcers before (1 January 2017-10 March 2020; n = 69) and during (11 March 2020-31 December 2022; n = 59) the COVID-19 pandemic from patients admitted with positive wound cultures to a regional hospital in Chiang Mai (Thailand). There was a marked reduction in AR rates from 78% pre-pandemic to 42% during the pandemic (p < 0.0001), with rates of polymicrobial infections 22 percentage points lower (from 61% to 39%, respectively; p = 0.014). There were reduced AR rates to amoxicillin/clavulanate (from 42% to 4%; p < 0.0001) and ampicillin (from 16% to 2%; p = 0.017), as well as multidrug resistance (19% to 8%; p = 0.026). Factors associated with increased AR odds were polymicrobial infections (adjusted odds ratio (aOR) 5.6 (95% CI 2.1, 15.0); p = 0.001), gram-negative bacteria (aOR 7.0 (95% CI 2.4, 20.5); p < 0.001), and prior use of antibiotics (aOR 11.9 (95% CI 1.1, 128.2); p = 0.041). Improvements in infection control measures and hygiene practices in the community during the pandemic were likely key factors contributing to lower AR rates. Thus, strategic public health interventions, including community education on hygiene and the informed use of antibiotics, may be crucial in mitigating the challenges posed by AR in CLTI. Further, advocating for more judicious use of empirical antibiotics in clinical settings can balance effective treatment against AR development, thereby improving patient outcomes.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.R.); (P.T.)
- Research Center for Infectious Disease and Substance Use, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pak Thaichana
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.R.); (P.T.)
| | - Nuttida Bunsermvicha
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - Rawee Nopparatkailas
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Supapong Arwon
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - Saranat Orrapin
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - Termpong Reanpang
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - Poon Apichartpiyakul
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - Saritphat Orrapin
- Department of Surgery, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani 12120, Thailand; (S.O.); (B.S.)
| | - Boonying Siribumrungwong
- Department of Surgery, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani 12120, Thailand; (S.O.); (B.S.)
| | - Nongkran Lumjuan
- Research Center for Molecular and Cell Biology, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.R.); (P.T.)
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.B.); (S.A.); (S.O.); (T.R.); (P.A.)
| | - José G. B. Derraik
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.R.); (P.T.)
- Department of Women’s and Children’s Health, Uppsala University, 75185 Uppsala, Sweden
- Department of Pediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand
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10
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Ehrenzeller S, Chen T, Vaidya V, Rhee C, Baker MA, Klompas M. Impact of SARS-CoV-2 Prevention Measures on Non-SARS-CoV-2 Hospital-Onset Respiratory Viral Infections: An Incidence Trend Analysis From 2015-2023. Clin Infect Dis 2023; 77:1696-1699. [PMID: 37531616 DOI: 10.1093/cid/ciad451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023] Open
Abstract
We reviewed hospital-onset respiratory viral infections, 2015-2023, in one hospital to determine whether Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission prevention measures prevented non-SARS-CoV-2 respiratory viral infections. Masking, employee symptom attestations, and screening patients and visitors for symptoms were associated with a 44%-53% reduction in hospital-onset influenza and respiratory syncytial virus (RSV), accounting for changes in community incidence.
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Affiliation(s)
- Selina Ehrenzeller
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tom Chen
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Vineeta Vaidya
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Chanu Rhee
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Meghan A Baker
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael Klompas
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
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11
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Wilson Dib R, Spallone A, Khawaja F, Feldman A, Cantu S, Chemaly RF. The impact of the COVID-19 pandemic on hospital-acquired infections at a comprehensive cancer center. Am J Infect Control 2023; 51:1302-1308. [PMID: 37804272 DOI: 10.1016/j.ajic.2023.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Robust infection prevention and control (IPC) measures were deployed across health care institutions at the start of the COVID-19 pandemic, resulting in increased use of personal protective equipment, enhanced contact precautions, and an emphasis on hand hygiene. Here, we evaluate the effect of enhanced IPC practices on the occurrence of various hospital-associated infections (HAIs) in a comprehensive cancer center. METHODS From September 2016 through March 2022, we calculated the incidence rates (IRs) of HAIs for C. difficile infection, multidrug-resistant organisms, respiratory viral infections (RVIs), and device-related infections. We analyzed the incidence rate ratios for all HAIs during the periods before the pandemic, during the pandemic, at the time of the surges, and in COVID-19-designated wards. RESULTS When comparing the prepandemic to the pandemic period, the IR across all MRDOs was similar. We observed a decrease in the IR of central line-associated bloodstream infections and a stable IR of catheter-associated urinary tract infections. A significant decrease was observed in the IR of C. difficile infection. The total IR of nosocomial RVIs decreased, as did for each respiratory virus. A similar IR of nosocomial RVIs between COVID-19 community surge versus nonsurge periods was observed except for SARS-CoV-2, RSV, and influenza. multidrug resistant organisms were 5 times more likely to occur on the COVID-19 wards compared with the non-COVID-19 wards. CONCLUSIONS Implementing strict IPC measures during the COVID-19 pandemic in a cancer hospital led to a significant decrease in many HAIs and a reduction in nosocomial RVIs.
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Affiliation(s)
- Rita Wilson Dib
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX; Division of Infectious Diseases, Department of Medicine, The University of Texas Health Science Center at Houston, Houston, TX
| | - Amy Spallone
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Fareed Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adina Feldman
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sherry Cantu
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Roy F Chemaly
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
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12
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Vicentini C, Russotto A, Bazzolo S, Rolfini E, Blengini V, Gamba D, Agodi A, Barchitta M, Bellio S, Fabbri E, Forni S, Ricchizzi E, Ripabelli G, Sticchi C, D’Ancona F“P, Zotti CM. Implementation of a centralized, web-based surveillance for healthcare associated infections among residents of long-term care facilities in Italy. PUBLIC HEALTH IN PRACTICE 2023; 6:100421. [PMID: 37661965 PMCID: PMC10472289 DOI: 10.1016/j.puhip.2023.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/24/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Objective The Italian National Action Plan to contrast AMR identified among its objectives the development and implementation of a national Healthcare-Associated Infection (HAI) surveillance system based on European Centre for Disease Prevention and Control (ECDC) indications, through point prevalence surveys (PPS) of HAIs and antibiotic use in acute-care hospitals and long-term care facilities (LTCFs). We aimed to assess feasibility and appropriateness of proposed tools for a national surveillance system of HAIs and antibiotic use in LTCFs. Study design Point prevalence survey. Methods A pilot PPS was conducted between May-June 2022, among 15 LTCFs of 7 Italian regions. Data were collected in a single day in each LTCF, at the LTCF, ward, and resident levels, using a web-based data collection tool developed ad hoc. Data collector teams of each facility were invited to complete a questionnaire investigating opinions on the proposed tools. Results Among 1025 included residents, the prevalence of residents with at least one HAI was 2.5% (95% CI 1.7%-3.7%) considering all HAIs and 2.2% (95% CI 1.3%-3%) without considering SARS-CoV-2 infections. The prevalence of antimicrobial use was 3% (95% CI 0.2%-4.3%). Overall, most respondents were satisfied with the web-based software, training and protocol, even though some difficulties were reported. Conclusions A national surveillance network was established, which will facilitate future surveillance efforts. Further studies are necessary to evaluate the impact of the pandemic on HAI transmission and antibiotic use in LTCFs.
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Affiliation(s)
- Costanza Vicentini
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - Antonino Russotto
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - Stefano Bazzolo
- Department of Environment, Land and Infrastructure Engineering (DIATI), Politecnico of Turin, Torino, Italy
| | - Edoardo Rolfini
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - Valentina Blengini
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - Dario Gamba
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
| | | | - Elisa Fabbri
- Agenzia Sanitaria e Sociale Regionale, Regione Emilia Romagna, Bologna, Italy
| | - Silvia Forni
- Agenzia Regionale di Sanità della Regione Toscana, Firenze, Italy
| | - Enrico Ricchizzi
- Agenzia Sanitaria e Sociale Regionale, Regione Emilia Romagna, Bologna, Italy
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | | | | | - Carla Maria Zotti
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
| | - working group “HALT pilota 2022”
- Department of Public Health and Paediatrics, University of Turin, Torino, Italy
- Department of Environment, Land and Infrastructure Engineering (DIATI), Politecnico of Turin, Torino, Italy
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
- Azienda Zero, Regione del Veneto, Padova, Italy
- Agenzia Sanitaria e Sociale Regionale, Regione Emilia Romagna, Bologna, Italy
- Agenzia Regionale di Sanità della Regione Toscana, Firenze, Italy
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
- A.Li.Sa, Regione Liguria, Genova, Italy
- Istituto Superiore di Sanità (ISS), Rome, Italy
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13
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Linn KZ, Sutjipto S, Ng OT, Teo J, Cherng BPZ, Tan TY, Pada SK, Ooi ST, Smitasin N, Thoon KC, Huan X, De PP, Chan D, Tee NWS, Ang M, Hsu LY, Lin RTP, Ng TY, Deepak RN, Koh TH, Apisarnthanarak A, Ponnampalavanar S, Venkatachalam I, Marimuthu K. Impact of COVID-19 pandemic on carbapenem-resistant Enterobacterales incidence in the South-East Asia region: an observational study. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e208. [PMID: 38156208 PMCID: PMC10753475 DOI: 10.1017/ash.2023.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 12/30/2023]
Abstract
The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.
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Affiliation(s)
- Kyaw Zaw Linn
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Stephanie Sutjipto
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Oon Tek Ng
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jeanette Teo
- National University Hospital and National University Health System, Singapore, Singapore
| | - Benjamin Pei Zhi Cherng
- Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | | | | | - Say Tat Ooi
- Khoo Teck Puat Hospital, Singapore, Singapore
| | - Nares Smitasin
- National University Hospital and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Koh Cheng Thoon
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Xiaowei Huan
- National Centre for Infectious Diseases, Singapore, Singapore
| | | | - Douglas Chan
- Ng Teng Fong General Hospital, Singapore, Singapore
| | - Nancy Wen Sim Tee
- National University Hospital and National University Health System, Singapore, Singapore
| | - Michelle Ang
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Li Yang Hsu
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Singapore Centre for Environmental Life Sciences Engineering, National University of Singapore, Singapore, Singapore
| | - Raymond Tzer Pin Lin
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- National Public Health Laboratory, Singapore, Singapore
| | | | | | - Tse Hsien Koh
- Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | | | | | | | - Kalisvar Marimuthu
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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14
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Abubakar U, Awaisu A, Khan AH, Alam K. Impact of COVID-19 Pandemic on Healthcare-Associated Infections: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2023; 12:1600. [PMID: 37998802 PMCID: PMC10668951 DOI: 10.3390/antibiotics12111600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023] Open
Abstract
This study investigated how the Coronavirus Disease 2019 (COVID-19) pandemic has affected the rate of healthcare-associated infections (HAIs). PubMed, Scopus and Google Scholar were searched to identify potentially eligible studies published from December 2019 to September 2022. A random effect model was used to determine the changes in the rate of HAIs during the pandemic. Thirty-seven studies, mostly from the United States (n = 13), were included. Fifteen studies described how the pandemic affected the rate of CLABSIs and CAUTIs, and eight of them showed a significant increase in CLABSIs. The risk of CLABSIs and CDIs was 27% (pooled odds ratio [OR]: 0.73; confidence interval [CI]: 0.61-0.89; p < 0.001) and 20% (pooled OR: 1.20; CI: 1.10-1.31; p < 0.001) higher during the pandemic compared to before the COVID-19 pandemic period, respectively. However, the overall risk of HAIs was unaffected by the pandemic (pooled OR: 1.00; 95 CI: 0.80-1.24; p = 0.990). Furthermore, there were no significant changes in the risk of CAUTIs (pooled OR: 1.01; 95 CI: 0.88-1.16; p = 0.890), and SSIs (pooled OR: 1.27; CI: 0.91-1.76; p = 0.16) between the two periods. The COVID-19 pandemic had no effect on the overall risk of HAIs among hospitalized patients, but an increased risk of CLABSIs and CDI were observed during the pandemic. Therefore, more stringent infection control and prevention measures and prudent interventions to promote the rational use of antibiotics are warranted across all healthcare facilities to reduce the burden of HAIs.
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Affiliation(s)
- Usman Abubakar
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Malaysia
| | - Khurshid Alam
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Malaysia
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15
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Barchitta M, Maugeri A, Favara G, Lio RMS, La Rosa MC, D'Ancona F, Agodi A. The intertwining of healthcare-associated infections and COVID-19 in Italian intensive care units: an analysis of the SPIN-UTI project from 2006 to 2021. J Hosp Infect 2023; 140:124-131. [PMID: 37562591 DOI: 10.1016/j.jhin.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/02/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Although healthcare-associated infections (HAIs) pose an extraordinary burden on public health, the impact of coronavirus disease 2019 (COVID-19) is still a matter of debate. AIM To describe trends of HAIs in Italian intensive care units (ICUs) from 2006 to 2021, and to compare characteristics and outcomes of patients with or without COVID-19. METHODS We evaluated patients participating in the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' (SPIN-UTI) project, who were admitted to ICUs for more than 48 h. Data regarding diagnosis, clinical conditions, therapies, treatments and outcomes of COVID-19 patients were also collected. FINDINGS From a total of 21,523 patients from 2006 to 2021, 3485 (16.2%) presented at least one HAI. We observed an increasing trend for both the incidence of patients with HAI and the incidence density of HAIs (P-trend <0.001). Compared with the pre-pandemic period, the incidence density of HAIs increased by about 15% in 2020-2021, with pneumoniae being the greatest contributors to this increase (P-trend <0.001). Moreover, incidence of HAIs was higher in ICUs dedicated to COVID-19 patients (P<0.001), who showed a greater risk of HAIs and death than patients without COVID-19 (P-values <0.001). Accordingly, the mortality in ICUs increased over the years and doubled during the pandemic (P-trend <0.001). Notably, co-infected patients had higher mortality (75.2%) than those with COVID-19 (66.2%) or HAI (39.9%) alone, and those without any infection (23.2%). CONCLUSIONS Our analysis provides useful insight into whether and how the COVID-19 pandemic influenced HAI incidence and death in Italian ICUs, highlighting the need for evaluation of the long-term effects of the pandemic.
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Affiliation(s)
- M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - A Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - G Favara
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - M C La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - F D'Ancona
- GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Istituto Superiore di Sanità, Rome, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI - Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico - San Marco', Catania, Italy.
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Schwaber MJ, Temkin E, Lobl R, Schechner V, Nutman A, Carmeli Y. Hospital-acquired bacterial infections in coronavirus disease 2019 (COVID-19) patients in Israel. Infect Control Hosp Epidemiol 2023; 44:1437-1442. [PMID: 36562287 DOI: 10.1017/ice.2022.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We sought to determine incidence of common hospital-acquired bacteria among coronavirus disease 2019 (COVID-19) patients in Israeli general hospitals during the first year of the pandemic. METHODS We analyzed routinely collected incidence data to determine hospital acquisition of the following sentinel bacteria: Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Pseudomonas aeruginosa, Acinetobacter baumannii, and Clostridioides difficile. We examined 3 acquisition measures: (1) sentinel bacteria, (2) sentinel bacteremia, and (3) antimicrobial-resistant sentinel bacteremia. The study period was March 1, 2020, through January 31, 2021. RESULTS Analysis of pooled data from the 26 hospitals surveyed revealed that rates were higher for all 3 acquisition measures among COVID-19 patients than they were among patients on general medical wards in 2019, but lower than those among patients in intensive care units in 2019. The incidence rate was highest during the first COVID-19 wave, despite a lower proportion of severe COVID-19 cases among total hospitalized during this wave. Wide variation in incidence was evident between hospitals. CONCLUSIONS Hospitalized COVID-19 patients experienced nosocomial bacterial infection at rates higher than those of patients on pre-pandemic general medical wards, adding to the complexity of their care. Lower rates of nosocomial infection after the first wave, despite higher proportions of severely ill patients, suggest that healthcare worker practices, rather than patient-related factors, were responsible for most of these infections.
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Affiliation(s)
- Mitchell J Schwaber
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elizabeth Temkin
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
| | - Rona Lobl
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
| | - Vered Schechner
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Nutman
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehuda Carmeli
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ali S, McDermott S. Impact of the COVID-19 pandemic on the incidence of healthcare-associated Clostridioides difficile infection in a tertiary healthcare facility in the Republic of Ireland. Infect Prev Pract 2023; 5:100300. [PMID: 37554737 PMCID: PMC10404766 DOI: 10.1016/j.infpip.2023.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/12/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Clostridioides difficile is the foremost cause of nosocomial infectious diarrhoea and one of the most prevalent healthcare associated infections (HAIs). AIMS To investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of healthcare associated C. difficile infection (HA-CDI). METHODS A retrospective study was conducted from January 2019-December 2022 inclusive at a tertiary University Hospital in Dublin, Ireland. The study period was divided into COVID-19 and non-COVID-19 periods determined in tangent with the then national incidences of COVID-19 and number of hospitalized patients with COVID-19. Analyses looked at quantity of testing performed, incidence rates and antimicrobial consumption. An independent samples t-test was used to determine significance between groups. RESULTS Between COVID-19 and non-COVID-19 periods, no statistically significant difference was observed among HA-CDI rates per 10,000 bed-days (2.1 cases vs 1.76 cases; P=0.34), consumption of defined daily doses per 100 bed-days of antimicrobials - all antimicrobials (83.36 vs 89.5; P=0.091), fluoroquinolones only (3.71 vs 4.46; P=0.067), third-generation cephalosporins only (4.17 vs 4.43; P=0.449), carbapenems only (3.28 vs 3.26; P=0.944) - or the number of C. difficile tests performed per 10,000 bed-days (321.81 tests vs 326.63 tests; P=0.696). CONCLUSIONS There was no difference in the incidence rates of HA-CDI between COVID-19 and non-COVID-19 periods at our institution.
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Affiliation(s)
- Saied Ali
- Department of Clinical Microbiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Sinead McDermott
- Department of Clinical Microbiology, St. Vincent's University Hospital, Dublin, Ireland
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Baumann I, Hage R, Gasche-Soccal P, Aubert JD, Schuurmans MM. Impact of SARS-CoV-2-Related Hygiene Measures on Community-Acquired Respiratory Virus Infections in Lung Transplant Recipients in Switzerland. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1473. [PMID: 37629763 PMCID: PMC10456728 DOI: 10.3390/medicina59081473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Community-acquired respiratory virus (CARV) infections pose a serious risk for lung transplant recipients (LTR) as they are prone to severe complications. When the COVID-19 pandemic hit Switzerland in 2020, the government implemented hygiene measures for the general population. We investigated the impact of these measures on the transmission of CARV in lung transplant recipients in Switzerland. Materials and Methods: In this multicenter, retrospective study of lung transplant recipients, we investigated two time periods: the year before the COVID-19 pandemic (1 March 2019-29 February 2020) and the first year of the pandemic (1 March 2020-28 February 2021). Data were mainly collected from the Swiss Transplant Cohort Study (STCS) database. Descriptive statistics were used to analyze the results. Results: Data from 221 Swiss lung transplant cohort patients were evaluated. In the year before the COVID-19 pandemic, 157 infections were diagnosed compared to 71 infections in the first year of the pandemic (decline of 54%, p < 0.001). Influenza virus infections alone showed a remarkable decrease from 17 infections before COVID-19 to 2 infections after the beginning of the pandemic. No significant difference was found in testing behavior; 803 vs. 925 tests were obtained by two of the three centers during the respective periods. Conclusions: We observed a significant decline in CARV infections in the Swiss lung transplant cohort during the first year of the COVID-19 pandemic. These results suggest a relevant impact of hygiene measures when implemented in the population due to the COVID-19 pandemic on the incidence of CARV infections.
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Affiliation(s)
- Isabelle Baumann
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland; (I.B.)
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - René Hage
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland; (I.B.)
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Paola Gasche-Soccal
- Division of Pulmonology, University Hospitals Geneva, 1205 Geneva, Switzerland
| | - John-David Aubert
- Division of Pulmonology, University Hospital Lausanne, 1011 Lausanne, Switzerland
| | - Macé M. Schuurmans
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland; (I.B.)
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
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19
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Listiowati E, Samsudin MA, Wulandari Y, Taritasari C, Mundakir M, Nurmansyah MI. Evaluating infection prevention and control structure of Indonesian COVID-19 referral hospitals. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2023; 15:1466. [PMID: 37781445 PMCID: PMC10407457 DOI: 10.4102/jamba.v15i1.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/09/2023] [Indexed: 10/03/2023]
Abstract
Due to the emergence of COVID-19, hospitals are required to increase vigilance in providing care. However, their readiness for infection prevention and control (IPC) as a referral hospital in providing COVID-19 services has not been determined. This study aims to evaluate the IPC structure of 30 private non-profit Indonesian referral hospitals for COVID-19 based on the World Health Organization Infection Prevention and Control Assessment Framework (WHO IPCAF). A descriptive cross-sectional quantitative study was used, where 30 hospitals as the COVID-19 referral hospital were selected. The data collection was conducted by an online survey using the IPCAF questionnaire created by the WHO and was analysed with descriptive analysis. The majority of the hospitals' IPC level is at an advanced level (73.3%). All type B hospitals have an advanced IPC level, while only 64.7% of type C and 71.4% of type D have an advanced level. The highest average IPC score is on the IPC guidelines component (94.0), while the lowest value of 71.9 is on the Surveillance of HAIs component. In the minimum scores, there were hospitals with the lowest scores in HAI Surveillance and Multimodal strategies, namely 20.0 and 25.0, respectively. Preparing human resource capacities, establishing functional programmes, developing and implementing IPC guidelines, and providing adequate supplies are needed to improve hospital IPC structures. Contribution This study demonstrates the necessity to improve hospital IPC structures to increase the resilience of health services to natural hazards and public health emergencies.
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Affiliation(s)
- Ekorini Listiowati
- Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Mohammad A. Samsudin
- Department of Management, Faculty of Economics, Social and Humanities, Universitas Aisyiyah Yogyakarta, Indonesia
| | - Yuanita Wulandari
- Department of Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | | | - Mundakir Mundakir
- Department of Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Mochamad I. Nurmansyah
- Department of Public Health, Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
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20
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Wright LM, Skinner AM, Cheknis A, McBurney C, Ge L, Pacheco SM, Leehey D, Gerding DN, Johnson S. Effect of the COVID-19 Pandemic on Rates and Epidemiology of Clostridioides difficile Infection in One VA Hospital. Antibiotics (Basel) 2023; 12:1159. [PMID: 37508255 PMCID: PMC10376799 DOI: 10.3390/antibiotics12071159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
The COVID-19 pandemic was associated with increases in some healthcare-associated infections. We investigated the impact of the pandemic on the rates and molecular epidemiology of Clostridioides difficile infection (CDI) within one VA hospital. We anticipated that the potential widespread use of antibiotics for pneumonia during the pandemic might increase CDI rates given that antibiotics are a major risk for CDI. Hospital data on patients with CDI and recurrent CDI (rCDI) were reviewed both prior to the COVID-19 pandemic (2015 to 2019) and during the pandemic (2020-2021). Restriction endonuclease analysis (REA) strain typing was performed on CD isolates recovered from stool samples collected from October 2019 to March 2022. CDI case numbers declined by 43.2% in 2020 to 2021 compared to the annual mean over the previous 5 years. The stool test positivity rate was also lower during the COVID-19 pandemic (14.3% vs. 17.2%; p = 0.013). Inpatient hospitalization rates declined, and rates of CDI among inpatients were reduced by 34.2% from 2020 to 2021. The mean monthly cases of rCDI also declined significantly after 2020 [3.38 (95% CI: 2.89-3.87) vs. 1.92 (95% CI: 1.27-2.56); p = <0.01]. Prior to the pandemic, REA group Y was the most prevalent CD strain among the major REA groups (27.3%). During the first wave of the pandemic, from 8 March 2020, to 30 June 2020, there was an increase in the relative incidence of REA group BI (26.7% vs. 9.1%); After adjusting for CDI risk factors, a multivariable logistic regression model revealed that the odds of developing an REA group BI CDI increased during the first pandemic wave (OR 6.41, 95% CI: 1.03-39.91) compared to the pre-pandemic period. In conclusion, the incidence of CDI and rCDI decreased significantly during the COVID-19 pandemic. In contrast, REA BI (Ribotype 027), a virulent, previously epidemic CD strain frequently associated with hospital transmission and outbreaks, reappeared as a prevalent strain during the first wave of the pandemic, but subsequently disappeared, and overall CDI rates declined.
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Affiliation(s)
- Lorinda M. Wright
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
| | - Andrew M. Skinner
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
- Chicago Stritch School of Medicine, Loyola University, 2160 S. First Ave., Maywood, IL 60153, USA
| | - Adam Cheknis
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
| | - Conor McBurney
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
| | - Ling Ge
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
| | - Susan M. Pacheco
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
- Chicago Stritch School of Medicine, Loyola University, 2160 S. First Ave., Maywood, IL 60153, USA
| | - David Leehey
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
- Chicago Stritch School of Medicine, Loyola University, 2160 S. First Ave., Maywood, IL 60153, USA
| | - Dale N. Gerding
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
| | - Stuart Johnson
- Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Hines, IL 60141, USA; (A.M.S.); (A.C.); (C.M.); (L.G.); (S.M.P.); (D.L.); (D.N.G.); (S.J.)
- Chicago Stritch School of Medicine, Loyola University, 2160 S. First Ave., Maywood, IL 60153, USA
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21
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Aslam S, Asrat H, Liang R, Qiu W, Sunny S, Maro A, Abdallah M, Fornek M, Episcopia B, Quale J. Methicillin-resistant Staphylococcus aureus bacteremia during the coronavirus disease 2019 (COVID-19) pandemic: Trends and distinguishing characteristics among patients in a healthcare system in New York City. Infect Control Hosp Epidemiol 2023; 44:1177-1179. [PMID: 36082528 DOI: 10.1017/ice.2022.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
During the pandemic, the rate of healthcare facility-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was 5 times greater in patients admitted with coronavirus disease 2019 (COVID-19). The presence of central lines and mechanical ventilation likely contribute to this increased rate. The number of central-line-associated bacteremia cases may be underestimated in patients with COVID-19.
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Affiliation(s)
- Saif Aslam
- Division of Infectious Diseases, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - Habtamu Asrat
- Division of Infectious Diseases, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - Rina Liang
- Department of Medicine, SUNY-Downstate Medical Center, Brooklyn, New York
| | - Wenqi Qiu
- School of Public Health, SUNY Downstate Medical Center, Brooklyn, New York
| | - Subin Sunny
- Department of Pharmacy Services, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - Anna Maro
- Division of Infectious Diseases, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - Marie Abdallah
- Division of Infectious Diseases, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - Mary Fornek
- Department of Infection Control and Prevention, NYC Health+Hospitals/Central Office, New York, New York
| | - Briana Episcopia
- Department of Infection Control and Prevention, NYC Health+Hospitals/Kings County, Brooklyn, New York
| | - John Quale
- Division of Infectious Diseases, NYC Health+Hospitals/Kings County, Brooklyn, New York
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22
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Freire MP, de Assis DB, Tavares BDM, Brito VOC, Marinho I, Lapchik M, Guedes AR, Madalosso G, Oliveira MS, de Lima ACP, Levin AS. Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance. Clinics (Sao Paulo) 2023; 78:100231. [PMID: 37348255 DOI: 10.1016/j.clinsp.2023.100231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. METHODS This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. RESULTS 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. CONCLUSIONS HAI increased during COVID-19. The microorganisms' susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use.
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Affiliation(s)
- Maristela Pinheiro Freire
- Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Denise Brandão de Assis
- Division of Hospital Infections, Center for Epidemiologic Surveillance "Prof. Alexandre Vranjac", Center for Disease Control, Sao Paulo State Health Department, São Paulo, SP, Brazil
| | - Bruno de Melo Tavares
- Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Valquiria O C Brito
- Núcleo Municipal de Controle de Infecção Hospitalar, São Paulo City Health Department, São Paulo, SP, Brazil
| | - Igor Marinho
- Department of Infectious Diseases, Laboratório de Investigacao Médica ‒ LIM 49, and Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Milton Lapchik
- Núcleo Municipal de Controle de Infecção Hospitalar, São Paulo City Health Department, São Paulo, SP, Brazil
| | - Ana Rubia Guedes
- Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Geraldine Madalosso
- Division of Hospital Infections, Center for Epidemiologic Surveillance "Prof. Alexandre Vranjac", Center for Disease Control, Sao Paulo State Health Department, São Paulo, SP, Brazil
| | - Maura Salaroli Oliveira
- Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | - Anna S Levin
- Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Department of Infectious Diseases, Laboratório de Investigacao Médica ‒ LIM 49, and Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
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23
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Lee YM, Kim DY, Kim EJ, Park KH, Lee MS. Impact of the coronavirus disease 2019 pandemic on healthcare-associated infections at intensive care units in South Korea: Data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS). J Hosp Infect 2023:S0195-6701(23)00164-0. [PMID: 37277015 PMCID: PMC10239201 DOI: 10.1016/j.jhin.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. The impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in intensive care units (ICUs) was evaluated. METHODS A retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System was conducted. Comparisons between incidence rates and microorganism distributions of bloodstream infections (BSIs), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated pneumonia (VAP) before and during the COVID-19 pandemic were performed according to hospital size. RESULTS The incidence rate of BSI significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period (1.38 vs. 1.23 per 10,000 patient-days, relative change -11.5%; P<0.001). The incidence rate of VAP (1.03 vs. 0.81 per 1,000 device-days, relative change -21.4%; P<0.001) significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period, whereas that rates of CLABSIs (2.30 vs. 2.23 per 1,000 device-days; P=0.19) and CAUTIs (1.26 vs. 1.26 per 1,000 device-days; P=0.99) were similar between the two periods. The rates of BSIs and CLABSIs significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates significantly decreased in small to medium-sized hospitals. The rates of CAUTI and VAP significantly decreased in small-sized hospitals. There were no significant changing trends in the rates of multidrug-resistant pathogens isolated from patients with HAIs between the two periods. CONCLUSION The incidence rates of BSI and VAP in ICUs decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. This decrease was mainly seen in small to medium-sized hospitals.
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Affiliation(s)
- Yu-Mi Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Dong Youn Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Eun Jin Kim
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, South Korea
| | - Ki-Ho Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Mi Suk Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
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24
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Wong SC, Chau PH, So SYC, Chiu KHY, Yuen LLH, AuYeung CHY, Lam GKM, Chan VWM, Chen JHK, Chen H, Li X, Ho PL, Chan SSC, Yuen KY, Cheng VCC. Epidemiology of multidrug-resistant organisms before and during COVID-19 in Hong Kong. Infect Prev Pract 2023; 5:100286. [PMID: 37223243 PMCID: PMC10165868 DOI: 10.1016/j.infpip.2023.100286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) has influenced antimicrobial consumption and incidence of multidrug-resistant organisms (MDROs). We aimed to study the epidemiology of MDROs before and during the COVID-19 pandemic in Hong Kong. Methods With the maintenance of infection control measures, we described the trend of MDRO infections, including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum-beta-lactamase-(ESBL)-producing Enterobacterales, in a healthcare region with 3100-bed before (1 January 2016 to 31 December 2019, period 1) and during COVID-19 (1 January 2020 to 30 September 2022, period 2), together with the antimicrobial consumption using piecewise Poisson regression. The epidemiological characteristics of newly diagnosed COVID-19 patients with or without MDRO infections were analyzed. Results Between period 1 and 2, we observed a significant increase in the trend of CRA infections (P<0.001), while there was no significant increase in the trend of MRSA (P=0.742) and ESBL-producing Enterobacterales (P=0.061) infections. Meanwhile, a significant increase in the trend of carbapenems (P<0.001), extended-spectrum beta-lactam-beta-lactamase inhibitor combinations (BLBI) (P=0.045), and fluoroquinolones (P=0.009) consumption was observed. The observed opportunity (23,540 ± 3703 vs 26,145 ± 2838, p=0.359) and compliance (81.6% ± 0.5% vs 80.1% ± 0.8%, P=0.209) of hand hygiene per year was maintained. In a multivariable model, older age, male sex, referral from residential care home for the elderly, presence of indwelling device, presence of endotracheal tube, and use of carbapenems, use of BLBI, use of proton pump inhibitors and history of hospitalization in the past 3 months were associated with higher risks of infections by MDROs among COVID-19 patients. Conclusion Infection control measures may control the surge of MDROs despite an increasing trend of antimicrobial consumption.
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Affiliation(s)
- Shuk-Ching Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Pui-Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Simon Yung-Chun So
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Kelvin Hei-Yeung Chiu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Lithia Lai-Ha Yuen
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Christine Ho-Yan AuYeung
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Germaine Kit-Ming Lam
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Veronica Wing-Man Chan
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Jonathan Hon-Kwan Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Hong Chen
- Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Xin Li
- Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Pak-Leung Ho
- Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sophia Siu-Chee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vincent Chi-Chung Cheng
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
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Garcell HG, Al-Ajmi J, Arias AV, Abraham JC, Garmendia AMF, Hernandez TMF. Catheter-associated urinary tract infection and urinary catheter utilization ratio over 9 years, and the impact of the COVID-19 pandemic on the incidence of infection in medical and surgical wards in a single facility in Western Qatar. Qatar Med J 2023; 2023:14. [PMID: 37521093 PMCID: PMC10373895 DOI: 10.5339/qmj.2023.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/02/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Catheter-associated urinary tract infection (CAUTI) is a frequently reported healthcare-associated infection in critical and non-critical patients. Limited data are available about CAUTI incidence in non-critical patients. We aim to describe the incidence of CAUTI over 9 years and evaluate the impact of the pandemic on the incidence in non-critical acute care patients. METHODS A retrospective observational study of CAUTI in medical-surgical and maternity wards was carried out at a public hospital in the west of the State of Qatar. Data collected included the annual CAUTI incidence (per 1,000 device days), urinary catheter utilization ratio (UC-UR), etiology, and antimicrobial resistance. RESULTS 115,238 patient days and 6,681 urinary catheters (UC) days were recorded over the study period, and 9 and 4 CAUTI were confirmed in medical-surgical and maternity wards, respectively. The infection rate was 1.9 per 1,000 UC days, and the UC-UR was 0.06. The CAUTI rate was higher in medical-surgical wards over the COVID-19 period (2.4 × 1,000 UC days) in comparison with the non-COVID-19 period (1.7 × 1,000 UC days) (RR 1.46; 1.12-1.80). However, in the maternity ward, the result was 0 and 2.5 × 1,000 UC days during these periods, respectively. No differences were observed in the infection rate among periods for all patients (RR 1.06; 0.81-1.31). Multidrug-resistant organisms were identified in 7 patients, and non-multidrug-resistant in 6 cases. CONCLUSION The study findings describe a lower CAUTI risk over 9 years in non-critical acute care patients. The impact of COVID-19 on the CAUTI risk is mainly related to medical patients who had previously been admitted to critical care. The infection control program should consider these data as a benchmark for quality improvement.
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Affiliation(s)
- Humberto Guanche Garcell
- Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Jameela Al-Ajmi
- Corporate Infection Control Department, Hamad Medical Corporation, Doha, Qatar
| | - Ariadna Villanueva Arias
- Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Joji C Abraham
- Corporate Infection Control Department, Hamad Medical Corporation, Doha, Qatar
| | - Angel M Felipe Garmendia
- Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Tania M Fernandez Hernandez
- Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
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Khatoon A, Aslam R, Bilal S, Naz S, Zaffar F, Khan SA, Ramzan RM, Noreen S, Phoolzaib K, Batool Z, Saleem K, Rasheed S. Assessment of risk factors and preventive measure compliance against COVID-19 among healthcare workers at tertiary care hospital: a retrospective study. GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc09. [PMID: 37261056 PMCID: PMC10227496 DOI: 10.3205/dgkh000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Introduction SARS-CoV-2 has created a significant challenge to healthcare systems, since the disease has spread rapidly, outweighing hospital capacity and exposing Health Care Workers (HCWs) to the risk of infection. The main objective of this study shows the HCW's self-reported use of Personal Protective Equipment (PPE), symptoms, and exposure to revealed and suspected people during the pandemic, as well as the implementation of infection prevention and control (IPC) guidelines that effectively limit the spread of the infection among healthcare personnel. Method A single-center retrospective cohort study has been done at a tertiary care hospital. There were 3,651 hospital employees of these 1,890 HCWs and 1,761 nonclinical staff among those who were proven or suspected COVID-19 cases and had symptoms were included. The data was gathered using a standardized self-assessment questionnaire. Information about quarantine protocol and line listing was collected through telephonic conversations. Result The majority of the participants were males (66%). The average age was 32.1±7.62. Out of 432 HCWs, 32.9% with positive SARS-CoV-2 PCR findings were nurses, 19.2% were doctors, and 47.9% were non-clinical employees from the hospital's inpatient and outpatient departments. 31.5% had a higher-risk exposure, 64.1% had a moderate-risk exposure, and 4.4% of practitioners with COVID-19 had a lower-risk exposure. A statistically significant association was found between COVID-19 disease and adherence to PPE and risk exposure. Conclusion This study represents the healthcare workers' experience with COVID-19 patients in the early stages of the pandemic and emphasizes the measures required to overcome the problems, however, this study highlights that HCWs are being progressively infected with COVID-19 as a result of inadequate/ inappropriate PPE wear.
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Affiliation(s)
- Arifa Khatoon
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Reema Aslam
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Shabnam Bilal
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Sadia Naz
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Farhan Zaffar
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Shahbaz Ahmed Khan
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Rao Muhammad Ramzan
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saima Noreen
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Kiran Phoolzaib
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Zahra Batool
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Kahsma Saleem
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saba Rasheed
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
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Sands KE, Blanchard EJ, Fraker S, Korwek K, Cuffe M. Health Care-Associated Infections Among Hospitalized Patients With COVID-19, March 2020-March 2022. JAMA Netw Open 2023; 6:e238059. [PMID: 37052918 PMCID: PMC10102879 DOI: 10.1001/jamanetworkopen.2023.8059] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Importance The reported incidence of many health care-associated infections (HAIs) increased during the COVID-19 pandemic; however, it is unclear whether this is due to increased patient risk or to increased pressure on the health care system. Objective To assess HAI occurrence among patients admitted to hospitals with and without COVID-19. Design, Setting, and Participants A cross-sectional retrospective analysis of inpatients discharged both with and without laboratory-confirmed COVID-19 infection was conducted. Data were obtained between January 1, 2019, and March 31, 2022, from community hospitals affiliated with a large health care system in the US. Exposure COVID-19 infection. Main Outcomes and Measures Occurrence of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and Clostridioides difficile infection as reported to the National Healthcare Safety Network. Results Among nearly 5 million hospitalizations in 182 hospitals between 2020 and 2022, the occurrence of health care-associated infections (HAIs) was high among the 313 200 COVID-19 inpatients (median [SD] age, 57 [27.3] years; 56.0% women). Incidence per 100 000 patient-days showed higher HAIs among those with COVID-19 compared with those without. For CLABSI, the incidence for the full 9 quarters of the study was nearly 4-fold higher among the COVID-19 population than the non-COVID-19 population (25.4 vs 6.9). For CAUTI, the incidence in the COVID-19 population was 2.7-fold higher in the COVID-19 population (16.5 vs 6.1), and for MRSA, 3.0-fold higher (11.2 vs 3.7). Quarterly trends were compared with the same quarter in 2019. The greatest increase in the incidence of HAI in comparison with the same quarter in 2019 for the entire population occurred in quarter 3 of 2020 for CLABSI (11.0 vs 7.3), quarter 4 of 2021 for CAUTI (7.8 vs 6.8), and quarter 3 of 2021 for MRSA (5.2 vs 3.9). When limited to the non-COVID-19 population, the increase in CLABSI incidence vs the 2019 incidence was eliminated, and the quarterly rates of MRSA and CAUTI were lower vs the prepandemic 2019 comparator quarter. Conclusions and Relevance In this cross-sectional study of hospitals during the pandemic, HAI occurrence among inpatients without COVID-19 was similar to that during 2019 despite additional pressures for infection control and health care professionals. The findings suggest that patients with COVID-19 may be more susceptible to HAIs and may require additional prevention measures.
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Topçu S, Emlek Sert Z. Turkish nursing students' compliance to standard precautions during the COVID-19 pandemic. PeerJ 2023; 11:e15056. [PMID: 36945360 PMCID: PMC10024895 DOI: 10.7717/peerj.15056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/22/2023] [Indexed: 03/18/2023] Open
Abstract
Objectives The aim of this study was to assess nursing students' compliance to standard precautions during the COVID-19 pandemic. Methods A cross-sectional study was conducted from December 2021 to June 2022, 816 nursing students participated in the study. A socio-demographic questionnaire and Compliance with Standard Precautions Scale were used to collect data. Means and percentages were used to report socio-demographic characteristics multiple regression analysis used to identify the factors influencing compliance with standard precautions. Results The mean age of nursing students was 21.30 ± 1.31 years. The majority of nursing students were female, with 703 (86.2%) being female and 113 (13.8%) being male. Compliance among nursing students was 76.8% overall. Nursing students reported the highest compliance (97.7%) with putting used sharp articles into sharp boxes, with 97.1% compliance for covering mouth and nose when wearing a mask. Participants reported the lowest (38.6%) when it came to not recapping used needles after giving an injection. Regression analysis revealed that gender, year of study, and having needlestick injury or contact with blood/body fluids experience all influenced nursing students' compliance with standard precautions. Conclusions During the pandemic, nursing students compliance to standard precautions was optimal, according to this study. More research should be done to assess nursing students' compliance with standard precautions and the effect of infection control strategies used to prevent COVID-19 transmission.
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Yao Z, Wu Y, Xu H, Lei Y, Long W, Li M, Gu Y, Jiang Z, Cao C. Prevalence and clinical characteristics of methicillin-resistant Staphylococcus aureus infections among dermatology inpatients: A 7-year retrospective study at a tertiary care center in southwest China. Front Public Health 2023; 11:1124930. [PMID: 36998271 PMCID: PMC10043400 DOI: 10.3389/fpubh.2023.1124930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundIncreased rates of methicillin-resistant Staphylococcus aureus (MRSA) antibiotic resistance and the associated morbidity have increased dermatologists' attention to skin and soft tissue MRSA infections. However, the clinical characterization of MRSA skin and soft tissue infections (SSTIs) in Southwest China is lacking, which precludes optimal prevention and treatment of these infections.ObjectivesThis study was conducted to characterize the prevalence, clinical comorbidities and antibiotic susceptibility of MRSA isolates from SSTIs, including community-associated (CA) and healthcare-associated (HA) isolates.MethodsIn the Dermatology Inpatient Department of the First Affiliated Hospital of Guangxi Medical University, a retrospective study was conducted on data, including patient demographics and clinical information, from culture-confirmed S. aureus isolated from skin and soft tissue between January 1, 2015, and December 31, 2021. Isolate susceptibility to 13 antibiotics was determined using the Vitek 2 system.ResultsFrom among 864 S. aureus strains, we identified 283 MRSA (32.75%) isolates comprising 203 CA-MRSA and 80 HA-MRSA isolates. The average rate of CA-MRSA isolation for MRSA SSTIs was 71.73%. The HA-MRSA isolation rate for MRSA SSTIs increased significantly. HA-MRSA-infected patients were older. The most common dermatological presentation of CA-MRSA infection was staphylococcal scalded skin syndrome, while the comorbidity severe drug eruption was significantly associated with HA-MRSA infection. One CA-MRSA strain was resistant to linezolid, and one HA-MRSA strain had an intermediate phenotype for vancomycin; both strains had low sensitivity to clindamycin and erythromycin (3.70%~19.40%). However, HA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole.ConclusionsCA-MRSA is a predominant pathogen causing SSTIs, and HA-MRSA infection incidence is increasing gradually. Both strains showed increasing antibiotic resistance. Our data on MRSA susceptibility may guide dermatologist antibiotic treatment decisions. Dermatologists should consider these identified comorbidities of MRSA SSTIs when patients are admitted and initiate early prevention and treatment of MRSA.
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Affiliation(s)
- Zhijian Yao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Mycosis Prevention and Treatment, Nanning, Guangxi, China
| | - Yidan Wu
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Mycosis Prevention and Treatment, Nanning, Guangxi, China
| | - Hongming Xu
- Department of Clinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Ying Lei
- Department of Clinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Wanyu Long
- Department of Clinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Meixian Li
- Department of Clinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yue Gu
- Department of Clinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhiwen Jiang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Mycosis Prevention and Treatment, Nanning, Guangxi, China
| | - Cunwei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Mycosis Prevention and Treatment, Nanning, Guangxi, China
- *Correspondence: Cunwei Cao
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Segala FV, Pafundi PC, Masciocchi C, Fiori B, Taddei E, Antenucci L, De Angelis G, Guerriero S, Pastorino R, Damiani A, Posteraro B, Sanguinetti M, De Pascale G, Fantoni M, Murri R. Incidence of bloodstream infections due to multidrug-resistant pathogens in ordinary wards and intensive care units before and during the COVID-19 pandemic: a real-life, retrospective observational study. Infection 2023:10.1007/s15010-023-02000-3. [PMID: 36867310 PMCID: PMC9983510 DOI: 10.1007/s15010-023-02000-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/07/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE SARS-COV-2 pandemic led to antibiotic overprescription and unprecedented stress on healthcare systems worldwide. Knowing the comparative incident risk of bloodstream infection due to multidrug-resistant pathogens in COVID ordinary wards and intensive care-units may give insights into the impact of COVID-19 on antimicrobial resistance. METHODS Single-center observational data extracted from a computerized dataset were used to identify all patients who underwent blood cultures from January 1, 2018 to May 15, 2021. Pathogen-specific incidence rates were compared according to the time of admission, patient's COVID status and ward type. RESULTS Among 14,884 patients for whom at least one blood culture was obtained, a total of 2534 were diagnosed with HA-BSI. Compared to both pre-pandemic and COVID-negative wards, HA-BSI due to S. aureus and Acinetobacter spp. (respectively 0.3 [95% CI 0.21-0.32] and 0.11 [0.08-0.16] new infections per 100 patient-days) showed significantly higher incidence rates, peaking in the COVID-ICU setting. Conversely, E. coli incident risk was 48% lower in COVID-positive vs COVID-negative settings (IRR 0.53 [0.34-0.77]). Among COVID + patients, 48% (n = 38/79) of S. aureus isolates were resistant to methicillin and 40% (n = 10/25) of K. pneumoniae isolates were resistant to carbapenems. CONCLUSIONS The data presented here indicate that the spectrum of pathogens causing BSI in ordinary wards and intensive care units varied during the pandemic, with the greatest shift experienced by COVID-ICUs. Antimicrobial resistance of selected high-priority bacteria was high in COVID positive settings.
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Affiliation(s)
- Francesco Vladimiro Segala
- Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Pia Clara Pafundi
- Facility of Epidemiology and Biostatistics, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carlotta Masciocchi
- Real World Data Facility, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eleonora Taddei
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Antenucci
- Real World Data Facility, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia De Angelis
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Guerriero
- Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Facility of Epidemiology and Biostatistics, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Damiani
- Real World Data Facility, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Brunella Posteraro
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gennaro De Pascale
- Department of Anesthesia and Intensive Care, Agostino Gemelli Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Fantoni
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rita Murri
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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The Impact of the COVID-19 Pandemic on the Prevalence of Multidrug-Resistant Organisms in Veterans Affairs Nursing Homes. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Alaidaroos OA, Almuhaydib MN, Alhossan MA, Aldossari AN, Fallatta MO, Alotaibi SM, Alowid FK, Salem AA, Alsaygh KA, Alshammary HS. Unexpected Benefits of Coronavirus Disease 2019: Impact of Coronavirus Disease 2019 Pandemic on Surgical Site Infection: A Systematic Review and Meta-Analysis. Surg Infect (Larchmt) 2023; 24:119-130. [PMID: 36847343 DOI: 10.1089/sur.2022.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Background: We aimed to summarize and synthesize the current evidence regarding the indirect impact of the coronavirus disease 2019 (COVID-19) pandemic and its associated measures on the surgical site infection (SSI) rate compared with the pre-pandemic period. Methods: A computerized search was conducted on MEDLINE via PubMed, Web of Science, and Scopus using the relevant keywords. Two-stage screening and data extraction were done. The National Institutes of Health (NIH) tools were used for the quality assessment. The Review Manager 5.4.1 program was used for the analysis. Results: Sixteen articles (n = 157,426 patients) were included. The COVID-19 pandemic and lockdown were associated with reduced risk of SSIs after surgery (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.56-0.75; p < 0.00001) and (OR, 0.49; 95% CI, 0.29-0.84; p = 0.009), respectively. There was no significant reduction in the SSIs rate after applying the extended use of masks (OR, 0.73; 95% CI, 0.30-1.73; p = 0.47). A reduction in the superficial SSI rate during the COVID-19 pandemic compared with the pre-COVID-19 pandemic period was observed (OR, 0.58; 95% CI, 0.45-0.75; p < 0.0001). Conclusions: The current evidence suggests that the COVID-19 pandemic may have some unexpected benefits, including improved infection control protocols, which resulted in reduced SSI rates, especially superficial SSIs. In contrast to extended mask use, the lockdown was associated with reduced rates of SSIs.
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Affiliation(s)
| | | | - Mashari Ahmed Alhossan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulkarem Naif Aldossari
- College of Medicine, Najran University, Najran, Saudi Arabia.,Emergency Department, King Khalid Hospital, Najran, Saudi Arabia
| | - Mawadda Omar Fallatta
- College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.,General Surgery Department, Althaghr Hospital, Jeddah, Saudi Arabia
| | | | - Fay Khalid Alowid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Impact of COVID-19 on the Surrounding Environment of Nursing Home Residents and Attitudes towards Infection Control and Oral Health Care among Nursing Home Staff in Japan. J Clin Med 2023; 12:jcm12051944. [PMID: 36902732 PMCID: PMC10003858 DOI: 10.3390/jcm12051944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
The environments of nursing home staff and residents have dramatically changed since the onset of the COVID-19 pandemic, with greater demand for infection control. This study aimed to clarify the changes and regional differences in the surrounding environment of nursing home residents as well as the working environment of staff, including oral health care, after the spread of SARS-CoV-2. A self-administered questionnaire survey was sent to nursing staff at about 40 nursing homes in different areas of Japan in September and October 2021. The questionnaire consisted of items centered around: (1) the surrounding environment of nursing home residents, (2) awareness and attitudes towards daily work among staff, and (3) attitudes to and procedures for oral health care among staff. A total of 929 respondents included 618 (66.5%) nursing care workers and 134 (14.4%) nurses. Regarding changes in resident daily life, 60% of staff perceived decreases in psychosocial and physical function after the start of the pandemic due to limited family communication and recreational activities, especially in urban areas. Concerning infection control, most respondents adopted routines of disinfecting hands before and after their duties. Oral health care was part of the regular duties of over 80% of respondents. Many participants answered that the frequency and time of oral health care only slightly changed after the onset of COVID-19, but many also reported disinfecting hands both before and after oral health care, particularly in rural areas. Our findings suggested that the COVID-19 pandemic decreased the daily living activities of residents, leading to psychosocial and physical decline, especially in urban areas. The results also indicated that the spread of SARS-CoV-2 triggered improvements in the awareness and attitudes towards infection control in daily work, including oral health care, among nursing care staff, notably in rural areas. Such an effect may contribute to a more positive perception of oral health care infection measures after the pandemic.
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Langford BJ, Soucy JPR, Leung V, So M, Kwan AT, Portnoff JS, Bertagnolio S, Raybardhan S, MacFadden DR, Daneman N. Antibiotic resistance associated with the COVID-19 pandemic: a systematic review and meta-analysis. Clin Microbiol Infect 2023; 29:302-309. [PMID: 36509377 PMCID: PMC9733301 DOI: 10.1016/j.cmi.2022.12.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND COVID-19 and antimicrobial resistance (AMR) are two intersecting global public health crises. OBJECTIVE We aimed to describe the impact of the COVID-19 pandemic on AMR across health care settings. DATA SOURCE A search was conducted in December 2021 in WHO COVID-19 Research Database with forward citation searching up to June 2022. STUDY ELIGIBILITY Studies evaluating the impact of COVID-19 on AMR in any population were included and influencing factors were extracted. Reporting of enhanced infection prevention and control and/or antimicrobial stewardship programs was noted. METHODS Pooling was done separately for Gram-negative and Gram-positive organisms. Random-effects meta-analysis was performed. RESULTS Of 6036 studies screened, 28 were included and 23 provided sufficient data for meta-analysis. The majority of studies focused on hospital settings (n = 25, 89%). The COVID-19 pandemic was not associated with a change in the incidence density (incidence rate ratio 0.99, 95% CI: 0.67-1.47) or proportion (risk ratio 0.91, 95% CI: 0.55-1.49) of methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci cases. A non-statistically significant increase was noted for resistant Gram-negative organisms (i.e. extended-spectrum beta-lactamase, carbapenem-resistant Enterobacterales, carbapenem or multi-drug resistant or carbapenem-resistant Pseudomonas aeruginosa or Acinetobacter baumannii, incidence rate ratio 1.64, 95% CI: 0.92-2.92; risk ratio 1.08, 95% CI: 0.91-1.29). The absence of reported enhanced infection prevention and control and/or antimicrobial stewardship programs initiatives was associated with an increase in gram-negative AMR (risk ratio 1.11, 95% CI: 1.03-1.20). However, a test for subgroup differences showed no statistically significant difference between the presence and absence of these initiatives (p 0.40). CONCLUSION The COVID-19 pandemic may have hastened the emergence and transmission of AMR, particularly for Gram-negative organisms in hospital settings. But there is considerable heterogeneity in both the AMR metrics used and the rate of resistance reported across studies. These findings reinforce the need for strengthened infection prevention, antimicrobial stewardship, and AMR surveillance in the context of the COVID-19 pandemic.
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Affiliation(s)
- Bradley J. Langford
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Corresponding author. Bradley J. Langford, Public Health Ontario, Health Protection, 480 University Avenue, Toronto, Ontario M5G 1V2, Canada
| | - Jean-Paul R. Soucy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Valerie Leung
- Public Health Ontario, Toronto, Ontario, Canada,Toronto East Health Network, Toronto, Ontario, Canada
| | - Miranda So
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Angela T.H. Kwan
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jacob S. Portnoff
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Silvia Bertagnolio
- Department of Surveillance, Prevention and Control, Division of Antimicrobial Resistance, World Health Organization, Geneva, Switzerland
| | | | - Derek R. MacFadden
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada,The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Nick Daneman
- Public Health Ontario, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: A systematic review. J Infect Public Health 2023; 16:320-331. [PMID: 36657243 PMCID: PMC9804969 DOI: 10.1016/j.jiph.2022.12.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is paucity of data describing the impact of COVID-19 pandemic on antimicrobial resistance. This review evaluated the changes in the rate of multidrug resistant gram negative and gram positive bacteria during the COVID-19 pandemic. METHODS A search was conducted in PubMed, Science Direct, and Google Scholar databases to identify eligible studies. Studies that reported the impact of COVID-19 pandemic on carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum beta-lactamase inhibitor (ESBL)-producing Enterobacteriaceae, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Pseudomonas aeruginosa (CPE) were selected. Studies published in English language from the start of COVID-19 pandemic to July 2022 were considered for inclusion. RESULTS Thirty eligible studies were selected and most of them were from Italy (n = 8), Turkey (n = 3) and Brazil (n = 3). The results indicated changes in the rate of multidrug resistant bacteria, and the changes varied between the studies. Most studies (54.5%) reported increase in MRSA infection/colonization during the pandemic, and the increase ranged from 4.6 to 170.6%. Five studies (55.6%) reported a 6.8-65.1% increase in VRE infection/colonization during the pandemic. A 2.4-58.2% decrease in ESBL E. coli and a 1.8-13.3% reduction in ESBL Klebsiella pneumoniae was observed during the pandemic. For CRAB, most studies (58.3%) reported 1.5-621.6% increase in infection/colonization during the pandemic. Overall, studies showed increase in the rate of CRE infection/colonization during the pandemic. There was a reduction in carbapenem-resistant E. coli during COVID-19 pandemic, and an increase in carbapenem-resistant K. pneumoniae. Most studies (55.6%) showed 10.4 - 40.9% reduction in the rate of CRPA infection during the pandemic. CONCLUSION There is an increase in the rate of multidrug resistant gram positive and gram negative bacteria during the COVID-19 pandemic. However, the rate of ESBL-producing Enterobacteriaceae and CRPA has decrease during the pandemic. Both infection prevention and control strategies and antimicrobial stewardship should be strengthen to address the increasing rate of multidrug resistant gram positive and gram negative bacteria.
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Asgill TF, Stupart D. Nosocomial bacterial infections in Victoria decreased during the COVID-19 pandemic. J Infect Prev 2023:17571774231159383. [PMCID: PMC9974379 DOI: 10.1177/17571774231159383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Background A number of infection control interventions were implemented during the COVID-19 pandemic in order to reduce the spread of this virus. Objective The purpose of this study was to determine if these interventions were associated with reduced nosocomial bacterial infections in Victoria, Australia. Methods Observational data were obtained from the Victorian Healthcare Associated Infection Surveillance System (VICNISS) based on admitted hospital patients in two 6-month timeframes representing pandemic and pre-pandemic hospital practices. Data were collected for surgical site infections, Staphylococcus aureus bacteraemia, Clostridioides difficile infection, and central line-associated bloodstream infections. Results There was a significant reduction in the rates of S. aureus bacteraemia (0.74 infections/10, 000 bed days pre-pandemic vs. 0.53/10,000 bed days in the pandemic period [rate ratio 0.72, 95% CI 0.57–0.90]; p = .003) and in C. difficile infections (2.2 infections/10,000 bed days pre-pandemic vs. 0.86/10 000 bed days in the pandemic era [rate ratio 0.76, 95% C.I. 0.67–0.86]; p <.001). There was no change in the overall rate of surgical site infections or central line-associated infections however. Discussion The increased emphasis on infection control and prevention strategies during the pandemic period was associated with reduced transmission of S. aureus and C. difficile infections within hospitals.
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Affiliation(s)
- Tess F Asgill
- Department of Surgery, University Hospital Geelong, Geelong, VIC, Australia,Tess F Asgill, Department of Surgery, University Hospital of Geelong, Bellerine St, Geelong, VIC 3220, Australia.
| | - Douglas Stupart
- Department of Surgery, University Hospital Geelong, Geelong, VIC, Australia,Department of Surgery, Deakin University, Geelong, VIC, Australia
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David SC. Technologies and therapeutics for ongoing prevention of respiratory infections. Clin Transl Immunology 2023; 12:e1442. [PMID: 36861031 PMCID: PMC9969962 DOI: 10.1002/cti2.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 03/03/2023] Open
Affiliation(s)
- Shannon C David
- Environmental Chemistry Laboratory, School of Architecture, Civil and Environmental EngineeringEcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
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Yang X, Liu X, Li W, Shi L, Zeng Y, Xia H, Huang Q, Li J, Li X, Hu B, Yang L. Epidemiological Characteristics and Antimicrobial Resistance Changes of Carbapenem-Resistant Klebsiella pneumoniae and Acinetobacter baumannii under the COVID-19 Outbreak: An Interrupted Time Series Analysis in a Large Teaching Hospital. Antibiotics (Basel) 2023; 12:antibiotics12030431. [PMID: 36978298 PMCID: PMC10044178 DOI: 10.3390/antibiotics12030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
Background: To investigate the epidemiological characteristics and resistance changes of carbapenem-resistant organisms (CROs) under the COVID-19 outbreak to provide evidence for precise prevention and control measures against hospital-acquired infections during the pandemic. Methods: The distribution characteristics of CROs (i.e., carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii) were analyzed by collecting the results of the antibiotic susceptibility tests of diagnostic isolates from all patients. Using interrupted time series analysis, we applied Poisson and linear segmented regression models to evaluate the effects of COVID-19 on the numbers and drug resistance of CROs. We also conducted a stratified analysis using the Cochran–Mantel–Haenszel test. Results: The resistance rate of carbapenem-resistant Acinetobacter baumannii (CRAB) was 38.73% higher after the COVID-19 outbreak compared with before (p < 0.05). In addition, the long-term effect indicated that the prevalence of CRAB had a decreasing trend (p < 0.05). However, the overall resistance rate of Klebsiella pneumoniae did not significantly change after the COVID-19 outbreak. Stratified analysis revealed that the carbapenem-resistant Klebsiella pneumoniae (CRKP) rate increased in females (OR = 1.98, p < 0.05), those over 65 years old (OR = 1.49, p < 0.05), those with sputum samples (OR = 1.40, p < 0.05), and those in the neurology group (OR = 2.14, p < 0.05). Conclusion: The COVID-19 pandemic has affected the change in nosocomial infections and resistance rates in CROs, highlighting the need for hospitals to closely monitor CROs, especially in high-risk populations and clinical departments. It is possible that lower adherence to infection control in crowded wards and staffing shortages may have contributed to this trend during the COVID-19 pandemic, which warrants further research.
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Affiliation(s)
- Xinyi Yang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xu Liu
- Department of Infectious Disease, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - Weibin Li
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lin Shi
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yingchao Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haohai Xia
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qixian Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jia Li
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaojie Li
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Bo Hu
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Correspondence: (B.H.); (L.Y.)
| | - Lianping Yang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Correspondence: (B.H.); (L.Y.)
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Trends in Pseudomonas aeruginosa ( P. aeruginosa) Bacteremia during the COVID-19 Pandemic: A Systematic Review. Antibiotics (Basel) 2023; 12:antibiotics12020409. [PMID: 36830319 PMCID: PMC9952731 DOI: 10.3390/antibiotics12020409] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/25/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is among the most common pathogens associated with healthcare-acquired infections, and is often antibiotic resistant, causing significant morbidity and mortality in cases of P. aeruginosa bacteremia. It remains unclear how the incidence of P. aeruginosa bacteremia changed during the Coronavirus Disease 2019 (COVID-19) pandemic, with studies showing almost contradictory conclusions despite enhanced infection control practices during the pandemic. This systematic review sought to examine published reports with incidence rates for P. aeruginosa bacteremia during (defined as from March 2020 onwards) and prior to the COVID-19 pandemic. A systematic literature search was conducted in accordance with PRISMA guidelines and performed in Cochrane, Embase, and Medline with combinations of the key words (pseudomonas aeruginosa OR PAE) AND (incidence OR surveillance), from database inception until 1 December 2022. Based on the pre-defined inclusion criteria, a total of eight studies were eligible for review. Prior to the pandemic, the prevalence of P. aeruginosa was on an uptrend. Several international reports found a slight increase in the incidence of P. aeruginosa bacteremia during the COVID-19 pandemic. These findings collectively highlight the continued importance of good infection prevention and control and antimicrobial stewardship during both pandemic and non-pandemic periods. It is important to implement effective infection prevention and control measures, including ensuring hand hygiene, stepping up environmental cleaning and disinfection efforts, and developing timely guidelines on the appropriate prescription of antibiotics.
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40
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Chang E, Im D, Lee HY, Lee M, Lee CM, Kang CK, Park WB, Kim NJ, Choe PG, Oh M. Impact of discontinuing isolation in a private room for patients infected or colonized with vancomycin-resistant enterococci (VRE) on the incidence of healthcare-associated VRE bacteraemia in a hospital with a predominantly shared-room setting. J Hosp Infect 2023; 132:1-7. [PMID: 36473555 DOI: 10.1016/j.jhin.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Isolating patients infected or colonized with vancomycin-resistant enterococci (VRE) in a private room or cohort room to prevent hospital transmission is controversial. AIM To evaluate the effect of a relaxed isolation policy for VRE-infected or colonized patients on healthcare-associated (HA) VRE bacteraemia in an acute care hospital with a predominantly shared-room setting. METHODS The incidence of HA VRE bacteraemia was compared during a private isolation era (October 2014-September 2017), a cohort isolation era (October 2017-June 2020), and a no isolation era (July 2020-June 2022). Using Poisson regression modelling, an interrupted time-series analysis was conducted to analyse level changes and trends in incidences of HA VRE bacteraemia for each era. FINDINGS The proportion of VRE-infected or -colonized patients staying in shared rooms increased from 18.3% in the private isolation era to 82.6% in the no isolation era (P < 0.001). There was no significant difference in the incidences of HA VRE bacteraemia between the private isolation era and the cohort isolation era (relative risk: 1.01; 95% confidence interval: 0.52-1.98; P = 0.977) or between the cohort isolation era and the no isolation era (0.99; 0.77-1.26; P = 0.903). In addition, there was no significant slope increase in the incidence of HA VRE bacteraemia between any of the eras. CONCLUSION In a hospital with predominantly shared rooms, the relaxation of isolation policy did not result in increased HA VRE bacteraemia, when other infection control measures were maintained.
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Affiliation(s)
- E Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D Im
- Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - H Y Lee
- Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - M Lee
- Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - C M Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - C K Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - W B Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - N J Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
| | - P G Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea.
| | - M Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea
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Healthcare-associated infections on the intensive care unit in 21 Brazilian hospitals during the early months of the coronavirus disease 2019 (COVID-19) pandemic: An ecological study. Infect Control Hosp Epidemiol 2023; 44:284-290. [PMID: 35300742 PMCID: PMC8987658 DOI: 10.1017/ice.2022.65] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and may have affected healthcare-associated infection (HAI) prevention strategies. We evaluated the impact of the COVID-19 pandemic on HAI incidence in Brazilian intensive care units (ICUs). METHODS In this ecological study, we compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (prepandemic period) in 21 Brazilian hospitals. We used the Wilcoxon signed rank-sum test in a pairwise analysis to compare the following differences between the pandemic and the prepandemic periods: microbiologically confirmed central-line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density (cases per 1,000 central line and ventilator days, respectively), the proportion of organisms that caused HAI, and antibiotic consumption (DDD). RESULTS We detected a significant increase in median CLABSI incidence during the pandemic: 1.60 (IQR, 0.44-4.20) vs 2.81 (IQR, 1.35-6.89) (P = .002). We did not detect a significant difference in VAP incidence between the 2 periods. In addition, we detected a significant increase in the proportion of CLABSI caused by Enterococcus faecalis and Candida spp during the pandemic, although only the latter retained statistical significance after correction for multiple comparisons. We did not detect a significant change in ceftriaxone, piperacillin-tazobactam, meropenem, or vancomycin consumption between the studied periods. CONCLUSIONS There was an increase in CLABSI incidence in Brazilian ICUs during the first months of COVID-19 pandemic. Additionally, we detected an increase in the proportion of CLABSI caused by E. faecalis and Candida spp during this period. CLABSI prevention strategies must be reinforced in ICUs during the COVID-19 pandemic.
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Zand F, Vakili H, Asmarian N, Masjedi M, Sabetian G, Nikandish R, Shafiee E, Tabatabaei Esfehani A, Azadi F, Sanaei Dashti A. Unintended impact of COVID-19 pandemic on the rate of catheter related nosocomial infections and incidence of multiple drug resistance pathogens in three intensive care units not allocated to COVID-19 patients in a large teaching hospital. BMC Infect Dis 2023; 23:11. [PMID: 36609225 PMCID: PMC9821351 DOI: 10.1186/s12879-022-07962-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 12/21/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. METHODOLOGY The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March-October 2019) and after (March-October 2020) the onset of COVID-19 pandemic in three ICU's, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens. RESULTS Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI 0.43-1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI 0.22-1.98, P = 0.469). CONCLUSION The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii.
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Affiliation(s)
- Farid Zand
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hedayatollah Vakili
- grid.412571.40000 0000 8819 4698Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoor Masjedi
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- grid.412571.40000 0000 8819 4698Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Nikandish
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Shafiee
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Tabatabaei Esfehani
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Azadi
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Sanaei Dashti
- grid.412571.40000 0000 8819 4698Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Verberk JDM, van der Kooi TII, Kampstra NA, Reimes N, van Rooden SM, Hopmans TEM, Geerlings SE, de Greeff SC. Healthcare-associated infections in Dutch hospitals during the COVID-19 pandemic. Antimicrob Resist Infect Control 2023; 12:2. [PMID: 36604755 PMCID: PMC9813899 DOI: 10.1186/s13756-022-01201-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic hospitals reorganized their resources and delivery of care, which may have affected the number of healthcare-associated infections (HAIs). We aimed to quantify changes in trends in the number of HAIs in Dutch hospitals during the COVID-19 pandemic. METHODS National surveillance data from 2016 to 2020 on the prevalence of HAIs measured by point prevalence surveys, and the incidence of surgical site infections (SSIs) and catheter-related bloodstream infections (CRBSIs) were used to compare rates between the pre-pandemic (2016-February 2020) and pandemic (March 2020-December 2020) period. RESULTS The total HAI prevalence among hospitalised patients was higher during the pandemic period (7.4%) compared to pre-pandemic period (6.4%), mainly because of an increase in ventilator-associated pneumonia (VAP), gastro-intestinal infections (GIs) and central nervous system (CNS) infections. No differences in SSI rates were observed during the pandemic, except for a decrease after colorectal surgeries (6.3% (95%-CI 6.0-6.6%) pre-pandemic versus 4.4% (95%-CI 3.9-5.0%) pandemic). The observed CRBSI incidence in the pandemic period (4.0/1,000 CVC days (95%-CI 3.2-4.9)) was significantly higher than predicted based on pre-pandemic trends (1.4/1000 (95%-CI 1.0-2.1)), and was increased in both COVID-19 patients and non-COVID-19 patients at the intensive care unit (ICU). CONCLUSIONS Rates of CRBSIs, VAPs, GIs and CNS infections among hospitalised patients increased during the first year of the pandemic. Higher CRBSI rates were observed in both COVID-19 and non-COVID-19 ICU population. The full scope and influencing factors of the pandemic on HAIs needs to be studied in further detail.
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Affiliation(s)
- Janneke D. M. Verberk
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands ,grid.7692.a0000000090126352Department of Medical Microbiology and Infection Prevention, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tjallie I. I. van der Kooi
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Nynke A. Kampstra
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Naomi Reimes
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Stephanie M. van Rooden
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Titia E. M. Hopmans
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Suzanne E. Geerlings
- grid.7177.60000000084992262Department of Internal Medicine, Amsterdam University Medical Centres, Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Sabine C. de Greeff
- grid.31147.300000 0001 2208 0118Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Antonie Van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
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Intestinal Carriage of Carbapenemase-Producing Enterobacteriaceae Members in Immunocompromised Children During COVID-19 Pandemic. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2023. [DOI: 10.5812/pedinfect-127183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Hospital-acquired infection with carbapenem-resistant Enterobacteriaceae (CRE) is a global concern. The administration of antibiotics among the infected and non-infected immunocompromised children with SARS-CoV-2 is associated with an increased risk of intestinal CRE colonization and bacteremia during hospitalization. Objectives: The present study aimed to detect the correlation between the intestinal colonization of carbapenemase encoding Enterobacteriaceae with SARS-CoV-2 infection and antibiotic prescription among immunocompromised children admitted to the oncology and Bone Marrow Transplantation (BMT) wards. Methods: Stool samples were collected from the immunocompromised children, and the members of Enterobacteriaceae were isolated using standard microbiological laboratory methods. Carbapenem resistance isolates were initially characterized by the disc diffusion method according to CLSI 2021 and further confirmed by the PCR assay. SARS-CoV-2 infection was also recorded according to documented real-time PCR results. Results: In this study, 102 Enterobacteriaceae isolates were collected from the stool samples. The isolates were from Escherichia spp. (59/102, 57.8%), Klebsiella spp. (34/102, 33.3%), Enterobacter spp. (5/102, 4.9%), Citrobacter spp. (2/102, 1.9%), and Serratia spp. (2/102, 1.9%). The carbapenem resistance phenotype was detected among 42.37%, 73.52%, 40%, 50%, and 100% of Escherichia spp., Klebsiella spp., Enterobacter spp., Citrobacter spp., and Serratia spp., respectively. Moreover, blaOXA-48 (49.1%) and blaNDM-1 (29.4%), as well as blaVIM (19.6%) and blaKPC (17.6%) were common in the CRE isolates. SARS-CoV-2 infection was detected in 50% of the participants; however, it was confirmed in 65.45% (36/55) of the intestinal CRE carriers. The administration of antibiotics, mainly broad-spectrum antibiotics, had a significant correlation with the CRE colonization in both the infected and non-infected children with SARS-CoV-2 infection. Conclusions: Regardless of the COVID-19 status, prolonged hospitalization and antibiotic prescription are major risk factors associated with the CRE intestinal colonization in immunocompromised children.
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Sunday AB, Nyasa RB, Mokake M. The influence of COVID-19 barrier measures on the positivity rate of typhoidal salmonellosis and amoebiasis in the Buea Health District, South West Region of Cameroon. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001854. [PMID: 37186243 PMCID: PMC10132537 DOI: 10.1371/journal.pgph.0001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/04/2023] [Indexed: 05/17/2023]
Abstract
Typhoidal salmonellosis and amoebiasis are prevalent in the Buea Health District (BHD) and it is evident that hand hygiene can reduce the transmissibility of these diseases. The barrier measures enforced by the government, in the wake of the corona virus disease 2019 (COVID-19) pandemic has led to behavioural changes which may have had an influence on the positivity rate of these diseases. This study seeks to determine the influence of COVID-19 barrier measures and the implementation of COVID-19 vaccination on the positivity rate of typhoidal salmonellosis and amoebiasis in the BHD. A retrospective study, with purposive and random sampling methods were used to select health facilities in BHD, whose laboratory records were reviewed using a data extraction form to obtain health information of patients who tested for typhoidal salmonella and/or Entamoeba histolytica from June 1, 2018 to December 31, 2021. Chi-square test was used to compare the positivity rate in the pre-and-COVID-19 and in the pre-and-vaccination era. The positivity rate of typhoidal salmonellosis and amoebiasis dropped from 57.8% and 2.7% in the pre-COVID-19 era to 34% and 1.8% in the COVID-19 era respectively, which were significant (χ2 = 945.8; P<0.001 and χ2 = 11.8; P = 0.001 respectively). Within the COVID-19 era, the positivity rate of salmonellosis and amoebiasis decreased from 39% and 2.6% before the implementation of COVID-19 vaccination to 27.7% and 0.8% respectively in the COVID-19 vaccination era and these differences were significant (χ2 = 149.1; P<0.001 and χ2 = 33.8; P<0.001 respectively). However, the positivity rate of salmonellosis between the rainy (43.5%) and the dry (42.8%) seasons and amoebiasis between the rainy (2.2%) and the dry (2%) seasons were not significantly different (χ2 = 0.6; P = 0.429 and χ2 = 0.54; P = 0.463 respectively). A significant decline in the positivity rate of typhoidal salmonellosis and amoebiasis was observed after the implementation of COVID-19 barrier measures and vaccination.
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Affiliation(s)
| | | | - Martin Mokake
- Department of Surgery and Obstetrics and Gynaecology, University of Buea, Buea, Cameroon
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Fitria N, Yulianita H, Sugiharto F, Astari DW, Eriyani T. The Factors Associated With Performance Among Infection Prevention and Control Linked Nurse During Covid-19 Pandemic. SAGE Open Nurs 2023; 9:23779608231193911. [PMID: 37559924 PMCID: PMC10408327 DOI: 10.1177/23779608231193911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/12/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
Background Infection Prevention and Control Linked Nurses (IPCLN) are the spearhead of implementing the Infection Control Prevention Program. The performance of nurses in preventing and controlling infections during the Covid-19 pandemic greatly influenced the quality of services. Objective This study aimed to determine the factors that influence the performance of IPCLN during the Covid-19 pandemic. Methods Cross-sectional study was performed on 34 nurses at Cicendo Eye Hospital with a total sampling technique. The questionnaire in this study included knowledge, motivation, supervision, and the performance of nurses which had previously been tested with these characteristics with a result of Cronbach's alpha of 0.75. Data were analyzed using univariate, bivariate, and multivariate analyses. Results The mean score of IPCLN knowledge in this study was 14.82 ± 4.01, motivation 92.47 ± 15.85, supervision 34.74 ± 5.89, and performance 7.94 ± 2.71. There is a relationship between knowledge (p = .000), motivation (p = .000), and supervision (p = .000) on nurse performance. Motivation is the dominant factor influencing IPCLN performance compared to knowledge and supervision (Stand. Estimate = 0.5121; 95% CI = 0.1301-0.487; p < .001). Conclusion Motivation is a dominant factor in IPCLN performance in this study. However, hospital management needs to maximize and make policies to improve IPCLN performance in terms of motivation. These policies can be through providing incentives for nurses, developing free continuing education programs, and issuing funds for nursing education scholarships.
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Affiliation(s)
- Nita Fitria
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Henny Yulianita
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | | | | | - Theresia Eriyani
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
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Healthcare-associated multispecies outbreaks of OXA-48-positive carbapenemase-producing Enterobacteriaceae in a Singapore tertiary-care hospital. Infect Control Hosp Epidemiol 2023; 44:8-16. [PMID: 35285435 DOI: 10.1017/ice.2022.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe OXA-48-like carbapenem-producing Enterobacteriaceae (CPE) outbreaks at Singapore General Hospital between 2018 and 2020 and to determine the risk associated with OXA-48 carriage in the 2020 outbreak. DESIGN Outbreak report and case-control study. SETTING Singapore General Hospital (SGH) is a tertiary-care academic medical center in Singapore with 1,750 beds. METHODS Active surveillance for CPE is conducted for selected high-risk patient cohorts through molecular testing on rectal swabs or stool samples. Patients with CPE are isolated or placed in cohorts under contact precautions. During outbreak investigations, rectal swabs are repeated for culture. For the 2020 outbreak, a retrospective case-control study was conducted in which controls were inpatients who tested negative for OXA-48 and were selected at a 1:3 case-to-control ratio. RESULTS Hospital wide, the median number of patients with healthcare-associated OXA-48 was 2 per month. In the 3-year period between 2018 and 2020, 3 OXA-48 outbreaks were investigated and managed, involving 4 patients with Klebsiella pneumoniae in 2018, 55 patients with K. pneumoniae or Escherichia coli in 2019, and 49 patients with multispecies Enterobacterales in 2020. During the 2020 outbreak, independent risk factors for OXA-48 carriage on multivariate analysis (49 patients and 147 controls) were diarrhea within the preceding 2 weeks (OR, 3.3; 95% CI, 1.1-10.7; P = .039), contact with an OXA-48-carrying patient (OR, 8.7; 95% CI, 1.9-39.3; P = .005), and exposure to carbapenems (OR, 17.2; 95% CI, 2.2-136; P = .007) or penicillin (OR, 16.6; 95% CI, 3.8-71.0; P < .001). CONCLUSIONS Multispecies OXA-48 outbreaks in our institution are likely related to a favorable ecological condition and selective pressure exerted by antimicrobial use. The integration of molecular surveillance epidemiology of the healthcare environment is important in understanding the risk of healthcare-associated infection to patients.
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Mpinganzima L, Ntaganda JM, Banzi W, Muhirwa JP, Nannyonga BK, Niyobuhungiro J, Rutaganda E. Analysis of COVID-19 mathematical model for predicting the impact of control measures in Rwanda. INFORMATICS IN MEDICINE UNLOCKED 2023; 37:101195. [PMID: 36819990 PMCID: PMC9930676 DOI: 10.1016/j.imu.2023.101195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
This paper shows the impact of control measures on the predictive COVID-19 mathematical model in Rwanda through sensitivity analysis of the basic reproduction number R 0 . We have introduced different levels of the control measures in the model, precisely, 90%, 80%, 60%, 40%, 20%, 0% and studied their effects on the variation of the model variables. The results from numerical simulations reveal that the more the adherence to the control measures at the percentage of 90%, 80%, 60%, 40%, 20%, 0%, the more the number of COVID-19 cases, hospitalized and deaths reduces which indicates the reduction of the spread of the pandemic in Rwanda. Moreover, It was shown that the transition rate from the infectious compartment is very sensitive to R 0 as the increase/decrease in its value increases/decreases the value of R 0 and this leads to the high spread or the containment of the pandemic respectively.
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Affiliation(s)
- Lydie Mpinganzima
- Department of Mathematics, University of Rwanda, P.O. Box 3900, Kigali, Rwanda
| | - Jean Marie Ntaganda
- Department of Mathematics, University of Rwanda, P.O. Box 3900, Kigali, Rwanda
| | - Wellars Banzi
- Department of Mathematics, University of Rwanda, P.O. Box 3900, Kigali, Rwanda
| | - Jean Pierre Muhirwa
- Department of Mathematics, University of Rwanda, P.O. Box 3900, Kigali, Rwanda,Corresponding author
| | - Betty Kivumbi Nannyonga
- Department of Mathematics, School of Physical Sciences, College of Natural Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Japhet Niyobuhungiro
- National Council for Science and Technology, 13th Floor, Grand Pension Plaza KN 2 Avenue, Nyarugenge - Kigali - Rwanda, P.O. Box 2285, Kigali, Rwanda
| | - Eric Rutaganda
- Department of Internal Medicine, Kigali University Teaching Hospital, P.O. Box 3286, Kigali, Rwanda
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Brink AJ, Richards G, Tootla H, Prentice E. Epidemiology of Gram-negative bacteria during coronavirus disease 2019. What is the real pandemic? Curr Opin Infect Dis 2022; 35:595-604. [PMID: 36345854 DOI: 10.1097/qco.0000000000000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE OF REVIEW Bacterial infections play a key role in hospital outcomes during the coronavirus disease 2019 (COVID-19) pandemic. Nonetheless, the global impact on the epidemiology of Gram-negative bacteria (GNB) and antibiotic resistance has not been clearly established. RECENT FINDINGS Multiple limitations exist in the current literature, in that substantial variability was observed with regard to methodology. Notwithstanding the heterogeneity, the evidence suggests that the COVID-19 pandemic had a substantial negative impact on global epidemiology with an increase in hospital-onset infections, associated with GNB. Similarly, an alarming increase in resistant GNB compared to prepandemic rates, was apparent. This was most evident for carbapenemase-producing Klebsiella pneumoniae (bloodstream infections), carbapenem-resistant Pseudomonas aeruginosa (ventilator-associated pneumonia), and carbapenem-resistant Acinetobacter baumannii (all infections). Significant variations were most apparent in the large, system-wide regional or national comparative assessments, vs. single-centre studies. Categorizing concurrent bacteria as co- or secondary-infections may be paramount to optimize standard of care. SUMMARY The data from most studies signal the probability that COVID-19 accelerated resistance. However, multiple limitations intrinsic to interpretation of current COVID-19 data, prevents accurately quantifying collateral damage on the global epidemiology and antibiotic resistance amongst GNB. It is likely to be substantial and renewed efforts to limit further increases is warranted.
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Affiliation(s)
- Adrian J Brink
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town.,National Health Laboratory Service, Groote Schuur Hospital, Cape Town
| | - Guy Richards
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Hafsah Tootla
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town.,National Health Laboratory Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Elizabeth Prentice
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town.,National Health Laboratory Service, Groote Schuur Hospital, Cape Town
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Bussolati E, Cultrera R, Quaranta A, Cricca V, Marangoni E, La Rosa R, Bertacchini S, Bellonzi A, Ragazzi R, Volta CA, Spadaro S, Scaramuzzo G. Effect of the Pandemic Outbreak on ICU-Associated Infections and Antibiotic Prescription Trends in Non-COVID19 Acute Respiratory Failure Patients. J Clin Med 2022; 11:jcm11237080. [PMID: 36498656 PMCID: PMC9739506 DOI: 10.3390/jcm11237080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had a relevant impact on the organization of intensive care units (ICU) and may have reduced the overall compliance with healthcare-associated infections (HAIs) prevention programs. Invasively ventilated patients are at high risk of ICU-associated infection, but there is little evidence regarding the impact of the pandemic on their occurrence in non-COVID-19 patients. Moreover, little is known of antibiotic prescription trends in the ICU during the first wave of the pandemic. The purpose of this investigation is to assess the incidence, characteristics, and risk factors for ICU-associated HAIs in a population of invasively ventilated patients affected by non-COVID-19 acute respiratory failure (ARF) admitted to the ICU in the first wave of the COVID-19 pandemic, and to evaluate the ICU antimicrobial prescription strategies. Moreover, we compared HAIs and antibiotic use to a cohort of ARF patients admitted to the ICU the year before the pandemic during the same period. METHODS this is a retrospective, single-centered cohort study conducted at S. Anna University Hospital (Ferrara, Italy). We enrolled patients admitted to the ICU for acute respiratory failure requiring invasive mechanical ventilation (MV) between February and April 2020 (intra-pandemic group, IP) and February and April 2019 (before the pandemic group, PP). We excluded patients admitted to the ICU for COVID-19 pneumonia. We recorded patients' baseline characteristics, ICU-associated procedures and devices. Moreover, we evaluated antimicrobial therapy and classified it as prophylactic, empirical or target therapy, according to the evidence of infection at the time of prescription and to the presence of a positive culture sample. We compared the results of the two groups (PP and IP) to assess differences between the two years. RESULTS One hundred and twenty-eight patients were screened for inclusion and 83 patients were analyzed, 45 and 38 in the PP and I group, respectively. We found a comparable incidence of HAIs (62.2% vs. 65.8%, p = 0.74) and multidrug-resistant (MDR) isolations (44.4% vs. 36.8% p= 0.48) in the two groups. The year of ICU admission was not independently associated with an increased risk of developing HAIs (OR = 0.35, 95% CI 0.16-1.92, p = 0.55). The approach to antimicrobial therapy was characterized by a significant reduction in total antimicrobial use (21.4 ± 18.7 vs. 11.6 ± 9.4 days, p = 0.003), especially of target therapy, in the IP group. CONCLUSIONS ICU admission for non-COVID-19 ARF during the first wave of the SARS-CoV-2 pandemic was not associated with an increased risk of ICU-associated HAIs. Nevertheless, ICU prescription of antimicrobial therapy changed and significantly decreased during the pandemic.
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Affiliation(s)
- Enrico Bussolati
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Rosario Cultrera
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Alessandra Quaranta
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Valentina Cricca
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Elisabetta Marangoni
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Riccardo La Rosa
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Sara Bertacchini
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Alessandra Bellonzi
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Riccardo Ragazzi
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Carlo Alberto Volta
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Savino Spadaro
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
| | - Gaetano Scaramuzzo
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Intensive Care Unit, Azienda Ospedaliera Universitaria Sant’Anna, 44121 Ferrara, Italy
- Correspondence:
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