Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

被引:31
|
作者
Martinez-Guerra, Bernardo A. [1 ]
Gonzalez-Lara, Maria F. [2 ]
de-Leon-Cividanes, Nereyda A. [1 ]
Tamez-Torres, Karla M. [2 ]
Roman-Montes, Carla M. [1 ]
Rajme-Lopez, Sandra [1 ]
Villalobos-Zapata, G. Ivonne [2 ]
Lopez-Garcia, Norma I. [2 ]
Martinez-Gamboa, Areli [2 ]
Sifuentes-Osornio, Jose [3 ]
Ortiz-Brizuela, Edgar [1 ]
Ochoa-Hein, Eric [4 ]
Galindo-Fraga, Arturo [4 ]
Bobadilla-del-Valle, Miriam [2 ]
Ponce-de-Leon, Alfredo [1 ]
机构
[1] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Infect Dis Dept, Mexico City 14080, DF, Mexico
[2] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Infect Dis Dept, Clin Microbiol Lab, Mexico City 14080, DF, Mexico
[3] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Med, Mexico City 14080, DF, Mexico
[4] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Infect Control & Hosp Epidemiol Dept, Mexico City 14080, DF, Mexico
来源
ANTIBIOTICS-BASEL | 2021年 / 10卷 / 02期
关键词
antimicrobial use; COVID-19; hospital-acquired infections; INFLUENZA; INFECTIONS; ADULTS;
D O I
10.3390/antibiotics10020182
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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.
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页码:1 / 9
页数:9
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