Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic
OBJECTIVE: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms.
METHODS: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI.
RESULTS: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05).
CONCLUSION: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Antibiotics (Basel, Switzerland) - 10(2021), 2 vom: 11. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Martinez-Guerra, Bernardo A [VerfasserIn] |
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| Links: |
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| Themen: |
Antimicrobial use |
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| Anmerkungen: |
Date Revised 16.03.2021 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/antibiotics10020182 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322276004 |
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| 500 | |a Date Revised 16.03.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a OBJECTIVE: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms | ||
| 520 | |a METHODS: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI | ||
| 520 | |a RESULTS: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05) | ||
| 520 | |a CONCLUSION: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a antimicrobial use | |
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| 700 | 1 | |a Gonzalez-Lara, Maria F |e verfasserin |4 aut | |
| 700 | 1 | |a de-Leon-Cividanes, Nereyda A |e verfasserin |4 aut | |
| 700 | 1 | |a Tamez-Torres, Karla M |e verfasserin |4 aut | |
| 700 | 1 | |a Roman-Montes, Carla M |e verfasserin |4 aut | |
| 700 | 1 | |a Rajme-Lopez, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Villalobos-Zapata, G Ivonne |e verfasserin |4 aut | |
| 700 | 1 | |a Lopez-Garcia, Norma I |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Gamboa, Areli |e verfasserin |4 aut | |
| 700 | 1 | |a Sifuentes-Osornio, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Ortiz-Brizuela, Edgar |e verfasserin |4 aut | |
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| 700 | 1 | |a Bobadilla-Del-Valle, Miriam |e verfasserin |4 aut | |
| 700 | 1 | |a Ponce-de-León, Alfredo |e verfasserin |4 aut | |
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