scholarly journals The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1146
Author(s):  
Aleksa Despotovic ◽  
Branko Milosevic ◽  
Andja Cirkovic ◽  
Ankica Vujovic ◽  
Ksenija Cucanic ◽  
...  

Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

Author(s):  
Septimiu Voidazan ◽  
Sorin Albu ◽  
Réka Toth ◽  
Bianca Grigorescu ◽  
Anca Rachita ◽  
...  

Background: Hospital-acquired infections (HAI) contribute to the emotional stress and functional disorders of the patient and in some cases, can lead to a state of disability that reduces quality of life. Often, HAI are one of the factors that lead to death. The purpose of this study was to analyze the cases of HAI identified in public hospitals at the county level, through case report sheets, as they are reported according to the Romanian legislation. Methods: We performed a cross sectional study design based on the case law of the data reported to the Mures Public Health Directorate, by all the public hospitals belonging to this county. We tracked hospital-acquired infections reported for 2017–2018, respectively, a number of 1024 cases, which implies a prevalence rate of 0.44%, 1024/228,782 cases discharged from these hospitals during the studied period. Results: The most frequent HAIs were reported by the intensive care units (48.4%), the most common infections being the following: bronchopneumonia (25.3%), enterocolitis with Clostridioides difficile (23.3%), sepsis, surgical wound infections and urinary tract infections. At the basis of HAI were 22 pathogens, but the five most common germs were Clostridioides difficile, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Bronchopneumonia have been most frequently reported in intensive care units, the most common being identified the Acinetobacter baumannii agent. Sepsis and central catheter infections also appeared predominantly in intensive care units, more often with Klebsiella pneumoniae. The enterocolitis with Clostridioides difficile, were the apanage of the medical sections. Infections with Staphylococcus aureus have been identified predominantly in the surgical sections at the level of the surgical wounds. Urinary infections had a similar distribution in the intensive care units, the medical and surgical sections, with Klebsiella pneumoniae being the most commonly incriminated agent. Conclusions: We showed a clear correspondence between the medical units and the type of HAI: what recommends the rapid, vigilant and oriented application of the prevention and control strategies of the HAI.


2020 ◽  
Vol 47 (3) ◽  
pp. 207-214
Author(s):  
M. Mukhtar-Yola ◽  
B. Andrew

Background: Health care workers at the bedside of critically ill babies freely carry their mobile phones in between procedures and handling  patients. Concerns are rising as this may contribute to nosocomial infections with pathogenic bacteria. Aim: To determine if mobile phones of health care workers in Intensive care units carry potentially pathogenic bacteria leading to hospital acquired infections. Design: Systematic review.Data sources: Electronic databases (Medline via ovid, CINAHL, Web of science) and hand Searching of references and citations were done to identify studies. Screening and inclusion criteria were used to identify studies with a cross-sectional or cohort design. The search was limited to journal articles published between 2008-2015 and to English language. Quality assessment was done using the National Institute of Health tool for observational studies. Data was extracted on to excel sheets and analysed using SPSS version 22.Results: Six studies with a cohort (1) or cross-sectional design (5) involving 1, 131 health care workers were reviewed. The overall quality of the studies was fair, and a narrative synthesis was done. The colonization rate of the mobile phones ranged between 46.3 % and a 100% with 13-50% carrying potentially pathogenic multidrug resistant microorganisms. Methicillin resistant staphylococcus aureus, Vancomycine resistant enterococci, acinobacter and coagulase negative staphylococci were reported across all studies and were recognized as leading causes of morbidity and mortalityin the ICU. Conclusion: Mobile phones Of HCW are portals of potentially pathogenic microorganisms, which could result in morbidity and mortality.Although no causal relationship could be established, strong associations have been reported. Guidelines by hospital infection control committees are needed on restriction, care and routine cleaning of mobile phones as well as further research. Key words: Health care worker, Intensive care unit, Hospital Acquired Infections, mobile phones


2019 ◽  
Vol 8 (9) ◽  
Author(s):  
Bárbara Magalhães ◽  
Laurence Senn ◽  
Dominique S. Blanc

Pseudomonas aeruginosa is one of the major Gram-negative pathogens responsible for hospital-acquired infections. Here, we present high-quality genome sequences of isolates from three P. aeruginosa genotypes retrieved from patients hospitalized in intensive care units.


2020 ◽  
Vol 20 (3) ◽  
pp. 1118-1123
Author(s):  
Nevin Ince ◽  
Dilek Yekenkurul ◽  
Ayşe Danış ◽  
Emel Çalışkan ◽  
İdris Akkaş

Background: Stenotrophomonas maltophilia is a Gram-negative bacillus and opportunistic emergent pathogen causing hospi- tal-acquired infections (HAIs). Due to risk factors such as prolonged intensive care unit stay and invasive procedures, it has become one of the leading causes of HAIs. Objective: The aim of this study was to evaluate the epidemiology of S.maltophilia infections over a six-year period at Düzce University Hospital, Turkey. Methods: The incidence, clinical characteristics, antimicrobial susceptibility and outcomes of nosocomial S. maltophilia in- fections during this period were retrospectively analyzed. Results: During the study period, 67 samples obtained from 61 patients were identified. Pneumonias (82%) were the most common HAIs, followed by bloodstream infections (10.5%), urinary tract infections (3%), skin and soft tissue infections (3%) and surgical site infection (1.5%). Admission to intensive care, hospitalization exceeding 30 days, and previous use of broad-spectrum antibiotics constituted risk factors. Resistance to cotrimoxazole (6%) was lower than that to levofloxacin (18%). Conclusion: The most important risk factors for S.maltophilia infection in patients are previous exposure to antibiotics, pro- longed hospitalization and invasive procedures such as mechanic ventilation. Discharging patients as early as possible with the rational use of antibiotics may be effective in reducing S. maltophilia infections and resistance rates. Keywords: Stenotrophomonas maltophilia; hospital-acquired infections; epidemiology; risk factors.


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