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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...

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Autores principales: 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
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
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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.
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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
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