W orksites that have had on-site operations during the coronavirus disease (COVID-19) pandemic have been vulnerable to COVID-19 outbreaks. The effect of COVID-19 on essential workers in food manufacturing has been well-described, but limited data exist on the burden of COVID-19 in other industry sectors (1). The high-density, fast-paced environments of food production facilities pose a barrier to proper adherence to COVID-19 prevention measures, such as social distancing, use of face coverings, and cleaning of shared spaces (2). These challenges are not unique to food production facilities. Furthermore, factors distinctive to other sectors, such as increased contact with the public, could similarly increase the risk of COVID-19 worksite exposure. A closer examination of the COVID-19 burden in multiple industry sectors, particularly within their specifi c subsectors, is warranted to provide a more complete characterization of the risk and impact of COVID-19 exposure in worksites.In Los Angeles County, California, USA, the fi rst COVID-19 worksite outbreak was identifi ed by the

A one-day point prevalence study to investigate the patterns of antibiotic use was undertaken in 43 latin American (LA) intensive care units. Of 510 patients admitted, 231 received antibiotic treatment on the day of the study (45%); in 125 cases (54%) due to nosocomial-acquired infections. The most frequent infection reported was nosocomial pneumonia (43%). Only in 122 patients (53%) were cultures performed before starting antibiotic treatment. 33% of the isolated microorganisms were enterobacteriaceae (40% extended-spectrum beta-lactamase-producing), 23% methicillin-resistant Staphylococcus aureus and 17% carbapenems-resistant non-fermentative Gram-negatives. The antibiotics most frequently prescribed were carbapenems (99/231, 43%); alone (60/99, 60%) or in combination with vancomycin (39/99, 40%). "Restricted" antibiotics (carbapenems, vancomycin, piperacillin-tazobactam, broad-spectrum cephalosporins, tigecycline, polymixins and linezolid) were most frequently indicated in severely ill patients (APACHE II score at admission >15, p=0.0007 and, SOFA score at the beginning of the antibiotic treatment >3, p=0.0000). Only 36% of antibiotic treatments were cultured-directed.Our findings help explain the high rates of multidrug-resistant pathogens in LA settings (i.e. ESBL-producing Gram-negatives) and the severity of the registered patients illnesses.

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