COVID-19大流行对医疗保健相关感染、抗生素耐药性和重症监护病房使用率的影响

Q2 Medicine Infezioni in Medicina Pub Date : 2023-01-01 DOI:10.53854/liim-3102-7
Uğur Önal, Ülkü Tüzemen, Esra Kazak, Neval Gençol, Esma Souleiman, Habibe İmer, Yasemin Heper, Emel Yılmaz, Cüneyt Özakın, Beyza Ener, Halıs Akalin
{"title":"COVID-19大流行对医疗保健相关感染、抗生素耐药性和重症监护病房使用率的影响","authors":"Uğur Önal,&nbsp;Ülkü Tüzemen,&nbsp;Esra Kazak,&nbsp;Neval Gençol,&nbsp;Esma Souleiman,&nbsp;Habibe İmer,&nbsp;Yasemin Heper,&nbsp;Emel Yılmaz,&nbsp;Cüneyt Özakın,&nbsp;Beyza Ener,&nbsp;Halıs Akalin","doi":"10.53854/liim-3102-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This paper aimed to evaluate the effects of the COVID-19 pandemic on healthcare-associated infections (HAIs), antibiotic resistance and consumption rates in intensive care units (ICUs) of a tertiary care university hospital.</p><p><strong>Patients and methods: </strong>Between 1 January 2018 and 31 December 2021, adult patients diagnosed with HAIs in ICUs were investigated retrospectively. Patients were divided into pre-pandemic (2018-2019) and pandemic periods (2020-2021). Antibiotic consumption index was calculated via using the formula of (total dose (grams)/defined daily dose (DDD) x total patient days) x1000. A p value below 0.05 was accepted as statistically significant.</p><p><strong>Results: </strong>The incidence of HAIs (per 1000 patient days) in the ICU of COVID-19 patients was 16.59, while it was 13.42 in the other ICUs during the pandemic period (p=0.107). The bloodstream infection (BSI) incidence was 3.32 in the pre-pandemic period and 5.41 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p<0.001). In the pandemic period, the BSI incidence rate was significantly higher in the ICU of COVID-19 patients than in the other ICUs (14.26 vs 5.41, p<0.001). Central venous catheter bloodstream infections incidence rate was 4.72 in the pre-pandemic and 7.52 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p=0.0019). During the pandemic period, the bacteraemia episode rates of <i>Acinetobacter baumannii</i> (5.375 vs 0.984, p<0.001), <i>Enterococcus spp</i>. (1.635 vs 0.268, p<0.001) and <i>Stenotrophomonas maltophilia</i> (3.038 vs 1.297, p=0.0086) in the ICU of COVID-19 patients were significantly found higher than others. The extended-spectrum beta-lactamase (ESBL) positivity rates for <i>Klebsiella pneumoniae</i> and <i>Escherichia coli</i> were 61% and 42% in the pre-pandemic period; 73% and 69% in the pandemic period in ICUs other than the ICU of COVID-19 patients (p>0.05). In the pandemic period, the ESBL positivity rates for <i>K. pneumoniae</i> and <i>E. coli</i> were 83% and 100% in the ICU of COVID-19 patients, respectively. Meropenem (p<0.001), teicoplanin (p<0.001) and ceftriaxone (p<0.001) consumptions were increased while ciprofloxacin (p=0.003) consumption was decreased in all ICUs after the pre-pandemic period.</p><p><strong>Conclusions: </strong>BSI and CVCBSI incidence rates were significantly increased in all ICUs after the COVID-19 pandemic in our hospital. Bacteraemia episode rates of <i>A. baumannii</i>, Enterococcus spp. and <i>S. maltophilia</i> in ICU of COVID-19 patients were significantly found higher than others. In addition, meropenem, teicoplanin and ceftriaxone consumptions were increased in all ICUs after the COVID-19 pandemic.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241394/pdf/1124-9390_31_1_2023_195-203.pdf","citationCount":"1","resultStr":"{\"title\":\"Effects of COVID-19 pandemic on healthcare-associated infections, antibiotic resistance and consumption rates in intensive care units.\",\"authors\":\"Uğur Önal,&nbsp;Ülkü Tüzemen,&nbsp;Esra Kazak,&nbsp;Neval Gençol,&nbsp;Esma Souleiman,&nbsp;Habibe İmer,&nbsp;Yasemin Heper,&nbsp;Emel Yılmaz,&nbsp;Cüneyt Özakın,&nbsp;Beyza Ener,&nbsp;Halıs Akalin\",\"doi\":\"10.53854/liim-3102-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This paper aimed to evaluate the effects of the COVID-19 pandemic on healthcare-associated infections (HAIs), antibiotic resistance and consumption rates in intensive care units (ICUs) of a tertiary care university hospital.</p><p><strong>Patients and methods: </strong>Between 1 January 2018 and 31 December 2021, adult patients diagnosed with HAIs in ICUs were investigated retrospectively. Patients were divided into pre-pandemic (2018-2019) and pandemic periods (2020-2021). Antibiotic consumption index was calculated via using the formula of (total dose (grams)/defined daily dose (DDD) x total patient days) x1000. A p value below 0.05 was accepted as statistically significant.</p><p><strong>Results: </strong>The incidence of HAIs (per 1000 patient days) in the ICU of COVID-19 patients was 16.59, while it was 13.42 in the other ICUs during the pandemic period (p=0.107). The bloodstream infection (BSI) incidence was 3.32 in the pre-pandemic period and 5.41 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p<0.001). In the pandemic period, the BSI incidence rate was significantly higher in the ICU of COVID-19 patients than in the other ICUs (14.26 vs 5.41, p<0.001). Central venous catheter bloodstream infections incidence rate was 4.72 in the pre-pandemic and 7.52 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p=0.0019). During the pandemic period, the bacteraemia episode rates of <i>Acinetobacter baumannii</i> (5.375 vs 0.984, p<0.001), <i>Enterococcus spp</i>. (1.635 vs 0.268, p<0.001) and <i>Stenotrophomonas maltophilia</i> (3.038 vs 1.297, p=0.0086) in the ICU of COVID-19 patients were significantly found higher than others. The extended-spectrum beta-lactamase (ESBL) positivity rates for <i>Klebsiella pneumoniae</i> and <i>Escherichia coli</i> were 61% and 42% in the pre-pandemic period; 73% and 69% in the pandemic period in ICUs other than the ICU of COVID-19 patients (p>0.05). In the pandemic period, the ESBL positivity rates for <i>K. pneumoniae</i> and <i>E. coli</i> were 83% and 100% in the ICU of COVID-19 patients, respectively. Meropenem (p<0.001), teicoplanin (p<0.001) and ceftriaxone (p<0.001) consumptions were increased while ciprofloxacin (p=0.003) consumption was decreased in all ICUs after the pre-pandemic period.</p><p><strong>Conclusions: </strong>BSI and CVCBSI incidence rates were significantly increased in all ICUs after the COVID-19 pandemic in our hospital. Bacteraemia episode rates of <i>A. baumannii</i>, Enterococcus spp. and <i>S. maltophilia</i> in ICU of COVID-19 patients were significantly found higher than others. In addition, meropenem, teicoplanin and ceftriaxone consumptions were increased in all ICUs after the COVID-19 pandemic.</p>\",\"PeriodicalId\":52423,\"journal\":{\"name\":\"Infezioni in Medicina\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241394/pdf/1124-9390_31_1_2023_195-203.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infezioni in Medicina\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.53854/liim-3102-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infezioni in Medicina","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.53854/liim-3102-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1

摘要

目的:评价2019冠状病毒病(COVID-19)大流行对某三级医院重症监护病房(icu)卫生保健相关感染(HAIs)、抗生素耐药性和用药率的影响。患者和方法:回顾性调查2018年1月1日至2021年12月31日期间icu中诊断为HAIs的成年患者。患者被分为大流行前(2018-2019年)和大流行期(2020-2021年)。使用(总剂量(克)/限定日剂量(DDD) x总患者天数)x1000计算抗生素消耗指数。p值小于0.05被认为有统计学意义。结果:疫情期间,新冠肺炎ICU患者HAIs发生率(每1000患者日)为16.59例,其他ICU为13.42例(p=0.107)。COVID-19非ICU ICU患者的血流感染(BSI)发生率在流行前期为3.32,流行期为5.41,其中ICU患者鲍曼pacinetobaci (5.375 vs 0.984)、戊特球菌(1.635 vs 0.268)、嗜麦寡养单胞菌(3.038 vs 1.297, p=0.0086)明显高于其他ICU患者。大流行前肺炎克雷伯菌和大肠杆菌的广谱β -内酰胺酶(ESBL)阳性率分别为61%和42%;COVID-19患者在大流行期非ICU的感染率分别为73%和69% (p>0.05)。疫情期间,重症监护病房肺炎克雷伯菌和大肠杆菌ESBL阳性率分别为83%和100%。结论:2019冠状病毒病大流行后,我院所有icu的BSI、CVCBSI发生率均显著升高。新型冠状病毒肺炎ICU患者鲍曼不动杆菌、肠球菌和嗜麦芽不动杆菌的菌血症发生率明显高于其他病例。此外,COVID-19大流行后,所有icu的美罗培南、替柯planin和头孢曲松用量均有所增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Effects of COVID-19 pandemic on healthcare-associated infections, antibiotic resistance and consumption rates in intensive care units.

Purpose: This paper aimed to evaluate the effects of the COVID-19 pandemic on healthcare-associated infections (HAIs), antibiotic resistance and consumption rates in intensive care units (ICUs) of a tertiary care university hospital.

Patients and methods: Between 1 January 2018 and 31 December 2021, adult patients diagnosed with HAIs in ICUs were investigated retrospectively. Patients were divided into pre-pandemic (2018-2019) and pandemic periods (2020-2021). Antibiotic consumption index was calculated via using the formula of (total dose (grams)/defined daily dose (DDD) x total patient days) x1000. A p value below 0.05 was accepted as statistically significant.

Results: The incidence of HAIs (per 1000 patient days) in the ICU of COVID-19 patients was 16.59, while it was 13.42 in the other ICUs during the pandemic period (p=0.107). The bloodstream infection (BSI) incidence was 3.32 in the pre-pandemic period and 5.41 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p<0.001). In the pandemic period, the BSI incidence rate was significantly higher in the ICU of COVID-19 patients than in the other ICUs (14.26 vs 5.41, p<0.001). Central venous catheter bloodstream infections incidence rate was 4.72 in the pre-pandemic and 7.52 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p=0.0019). During the pandemic period, the bacteraemia episode rates of Acinetobacter baumannii (5.375 vs 0.984, p<0.001), Enterococcus spp. (1.635 vs 0.268, p<0.001) and Stenotrophomonas maltophilia (3.038 vs 1.297, p=0.0086) in the ICU of COVID-19 patients were significantly found higher than others. The extended-spectrum beta-lactamase (ESBL) positivity rates for Klebsiella pneumoniae and Escherichia coli were 61% and 42% in the pre-pandemic period; 73% and 69% in the pandemic period in ICUs other than the ICU of COVID-19 patients (p>0.05). In the pandemic period, the ESBL positivity rates for K. pneumoniae and E. coli were 83% and 100% in the ICU of COVID-19 patients, respectively. Meropenem (p<0.001), teicoplanin (p<0.001) and ceftriaxone (p<0.001) consumptions were increased while ciprofloxacin (p=0.003) consumption was decreased in all ICUs after the pre-pandemic period.

Conclusions: BSI and CVCBSI incidence rates were significantly increased in all ICUs after the COVID-19 pandemic in our hospital. Bacteraemia episode rates of A. baumannii, Enterococcus spp. and S. maltophilia in ICU of COVID-19 patients were significantly found higher than others. In addition, meropenem, teicoplanin and ceftriaxone consumptions were increased in all ICUs after the COVID-19 pandemic.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
期刊最新文献
The current state of knowledge on dracunculiasis: a narrative review of a rare neglected disease Historical account of clinical observations on leprosy and related manifestations in the Comacchio area, Italy, in the XIX century Clinical utility of intrabronchial antifungal instillation in a complicated case of chronic pulmonary aspergillosis: case report and systematic review of literature Did the updated Duke criteria missed Erysipelothrix rhusiopathiae from the list of typical microorganisms causing infective endocarditis? The role of long-acting antibiotics in the clinical practice: a narrative review
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1