A multidrug-resistant <i>Klebsiella pneumoniae</i> outbreak in a Peruvian hospital: Another threat from the COVID-19 pandemic

Arteaga‐Livias, Kovy; Pinzas-Acosta, Karim; Perez-Abad, Lourdes; Panduro-Correa, Vicky; Rabaan, Ali A.; Pecho-Silva, Samuel; Dámaso-Mata, Bernardo

doi:10.1017/ice.2020.1401

Cited by 37 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During the COVID-19 pandemic, the spread of carbapenem-resistant K. pneumoniae isolates in ICU patients has been documented. This was attributed to high rates of antimicrobial use, transmissions due to the high intensity of care, the increased burden on hospitals, and the difficulties of working with full personal equipment [31][32][33]. In our cohort, we observed only one case of transmission of carbapenem-resistant OXA-48 carbapenemase-positive K. oxytoca.…”

Section: Discussionmentioning

confidence: 68%

Dexamethasone therapy and rates of secondary pulmonary and bloodstream infections in critically ill COVID-19 patients

et al. 2021

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 (COVID-19) has become a pandemic. Bacterial superinfections seem to be associated with higher mortality in COVID-19 patients in intensive care units (ICUs). However, details on the prevalence and species distribution of secondary infections are limited. Moreover, the increasing use of dexamethasone may pose an additional risk of superinfections.Methods: We performed a single-center retrospective study of the clinical and microbiological characteristics of 154 COVID-19 patients admitted to the ICU between March 2020 and January 2021, focusing on bacterial infections, use of antimicrobial agents and dexamethasone therapy.Results: The median age was 68 years; 67.5% of the patients were men. Critically ill COVID-19 patients were treated with dexamethasone since July 2020 (second wave), which was not common during the first wave of the pandemic. In the dexamethasone group (n=90, 58.4%), respiratory pathogens were detected more frequently, as were multidrug-resistant pathogens. The number of patients with polymicrobial detection of respiratory pathogens was significantly increased (p=0.013). The most frequently detected species were Enterobacterales, Staphylococcus aureus, and Aspergillus fumigatus. The rates of bloodstream infections did not differ between the groups. The use of dexamethasone in ICU COVID-19 patients was associated with higher rates of respiratory infectious complications.Conclusions: Secondary infections are present in a substantial fraction of critically ill COVID-19 patients. Respiratory pathogens were detectable in the majority of COVID-19 ICU patients. The use of dexamethasone poses a potential risk of secondary pulmonary infections. Infectious complications in patients with dexamethasone therapy could be associated with worse outcomes.

show abstract

Section: Discussionmentioning

confidence: 68%

Dexamethasone therapy and rates of secondary pulmonary and bloodstream infections in critically ill COVID-19 patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The spread of multidrug-resistant (MDR) bacteria, especially Klebsiella MDR during the COVID-19 era, was facilitated by the increased consumption of antibiotics during this period. International studies indicate that approximately 70% of hospitalized patients with COVID-19 receive antibiotics, most often with broad spectrums, despite a lack of evidence of bacterial coinfections [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Carbapenem-Resistant Klebsiella pneumoniae Associated with COVID-19

Dumitru

Dumitrașcu²,

Vlad

et al. 2021

Antibiotics

View full text Add to dashboard Cite

Infections with carbapenem-resistant Enterobacteriaceae are emerging as an important challenge in healthcare settings. Currently, carbapenem-resistant Klebsiella pneumoniae (CRKP) are the species of CRE most commonly encountered in hospitals. CRKP is resistant to almost all available antimicrobial agents, and infections with CRKP have been associated with high rates of morbidity and mortality, particularly among persons with prolonged hospitalization exposed to invasive devices. We report nine patients hospitalized in an intensive care unit (ICU) with severe coronavirus disease 2019 (COVID-19) who developed invasive infections due to carbapenemase-producing Klebsiella pneumoniae (CP-Kp), KPC and OXA-48, strains that have not been previously identified in our hospital. Despite ceftazidime/avibactam therapy, five patients died. Coinfections can contribute to a poor prognosis for patients with COVID-19, especially for high-risk populations such as elderly patients. Therefore, it is crucial to establish a rigorous program of antibiotic administration in intensive care units.

show abstract

“…To this regard, Yang et al [46] observed a higher rate of CRE colonization in patients where positioning (prone position) was used in the treatment process, if compared with patients who were not prone-positioned (67% vs. 37%). Despite the lack of a clear explanation for this result, it is possible that a combination of wide antibiotic prescription, higher severity of prone-positioned patients, and employment of additional staff who often had no experience of working in the ICU [47] caused this phenomenon.…”

Section: Carbapenem-resistant Enterobacteriaceaementioning

confidence: 99%

Impact of SARS-CoV-2 Epidemic on Antimicrobial Resistance: A Literature Review

Segala

Bavaro

Gennaro

et al. 2021

Viruses

View full text Add to dashboard Cite

Antimicrobial resistance is an urgent threat to public health and global development; in this scenario, the SARS-CoV2 pandemic has caused a major disruption of healthcare systems and practices. A narrative review was conducted on articles focusing on the impact of COVID-19 on multidrug-resistant gram-negative, gram-positive bacteria, and fungi. We found that, worldwide, multiple studies reported an unexpected high incidence of infections due to methicillin-resistant S. aureus, carbapenem-resistant A. baumannii, carbapenem-resistant Enterobacteriaceae, and C. auris among COVID-19 patients admitted to the intensive care unit. In this setting, inappropriate antimicrobial exposure, environmental contamination, and discontinuation of infection control measures may have driven selection and diffusion of drug-resistant pathogens.

show abstract

A multidrug-resistant Klebsiella pneumoniae outbreak in a Peruvian hospital: Another threat from the COVID-19 pandemic

Cited by 37 publications

References 10 publications

Dexamethasone therapy and rates of secondary pulmonary and bloodstream infections in critically ill COVID-19 patients

Dexamethasone therapy and rates of secondary pulmonary and bloodstream infections in critically ill COVID-19 patients

Carbapenem-Resistant Klebsiella pneumoniae Associated with COVID-19

Impact of SARS-CoV-2 Epidemic on Antimicrobial Resistance: A Literature Review

Contact Info

Product

Resources

About