Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917840/ https://www.ncbi.nlm.nih.gov/pubmed/33670316 http://dx.doi.org/10.3390/antibiotics10020182 |
_version_ | 1783657789988536320 |
---|---|
author | Martinez-Guerra, Bernardo A. Gonzalez-Lara, Maria F. de-Leon-Cividanes, Nereyda A. Tamez-Torres, Karla M. Roman-Montes, Carla M. Rajme-Lopez, Sandra Villalobos-Zapata, G. Ivonne Lopez-Garcia, Norma I. Martínez-Gamboa, Areli Sifuentes-Osornio, Jose Ortiz-Brizuela, Edgar Ochoa-Hein, Eric Galindo-Fraga, Arturo Bobadilla-del-Valle, Miriam Ponce-de-León, Alfredo |
author_facet | Martinez-Guerra, Bernardo A. Gonzalez-Lara, Maria F. de-Leon-Cividanes, Nereyda A. Tamez-Torres, Karla M. Roman-Montes, Carla M. Rajme-Lopez, Sandra Villalobos-Zapata, G. Ivonne Lopez-Garcia, Norma I. Martínez-Gamboa, Areli Sifuentes-Osornio, Jose Ortiz-Brizuela, Edgar Ochoa-Hein, Eric Galindo-Fraga, Arturo Bobadilla-del-Valle, Miriam Ponce-de-León, Alfredo |
author_sort | Martinez-Guerra, Bernardo A. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7917840 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79178402021-03-02 Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic Martinez-Guerra, Bernardo A. Gonzalez-Lara, Maria F. de-Leon-Cividanes, Nereyda A. Tamez-Torres, Karla M. Roman-Montes, Carla M. Rajme-Lopez, Sandra Villalobos-Zapata, G. Ivonne Lopez-Garcia, Norma I. Martínez-Gamboa, Areli Sifuentes-Osornio, Jose Ortiz-Brizuela, Edgar Ochoa-Hein, Eric Galindo-Fraga, Arturo Bobadilla-del-Valle, Miriam Ponce-de-León, Alfredo Antibiotics (Basel) Article 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. MDPI 2021-02-11 /pmc/articles/PMC7917840/ /pubmed/33670316 http://dx.doi.org/10.3390/antibiotics10020182 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Martinez-Guerra, Bernardo A. Gonzalez-Lara, Maria F. de-Leon-Cividanes, Nereyda A. Tamez-Torres, Karla M. Roman-Montes, Carla M. Rajme-Lopez, Sandra Villalobos-Zapata, G. Ivonne Lopez-Garcia, Norma I. Martínez-Gamboa, Areli Sifuentes-Osornio, Jose Ortiz-Brizuela, Edgar Ochoa-Hein, Eric Galindo-Fraga, Arturo Bobadilla-del-Valle, Miriam Ponce-de-León, Alfredo Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title | Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title_full | Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title_fullStr | Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title_full_unstemmed | Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title_short | Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic |
title_sort | antimicrobial resistance patterns and antibiotic use during hospital conversion in the covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917840/ https://www.ncbi.nlm.nih.gov/pubmed/33670316 http://dx.doi.org/10.3390/antibiotics10020182 |
work_keys_str_mv | AT martinezguerrabernardoa antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT gonzalezlaramariaf antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT deleoncividanesnereydaa antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT tameztorreskarlam antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT romanmontescarlam antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT rajmelopezsandra antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT villaloboszapatagivonne antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT lopezgarcianormai antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT martinezgamboaareli antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT sifuentesosorniojose antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT ortizbrizuelaedgar antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT ochoaheineric antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT galindofragaarturo antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT bobadilladelvallemiriam antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic AT poncedeleonalfredo antimicrobialresistancepatternsandantibioticuseduringhospitalconversioninthecovid19pandemic |