The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study

Gajić, Ina; Jovićević, Miloš; Popadić, Višeslav; Trudić, Anika; Kabić, Jovana; Kekić, Dušan; Ilic, A.; Klašnja, Slobodan; Hadnadjev, M.; Popadic, D.J.; Andrijevic, A.; Prokic, A.; Tomasevic, R.; Ranin, Lazar; Todorovic, Z.; Zdravković, Marija; Opavski, Nataša

doi:10.1016/j.jhin.2023.04.013

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…Our study showed a high mortality rate in both study groups similar to other studies [ 7 , 13 , 14 , 15 , 16 ]. Possible explanations for this high mortality include the high percentage of septic shock (88.6% in the COVID-19 and 58.1% in the non-COVID-19 group, respectively), the high incidence of organ failure (e.g., ARDS 78.4% in COVID-19 and 48.4% in non-COVID-19, respectively), AKI stage 3 (25.5% in COVID-19 and 32.2% in non-COVID-19, respectively), the high percentage of VAP (55.5% in the COVID-19 population) and the high severity of illness (the median SOFA score on day 1 of sepsis was 9) that are known risk factors associated with increased mortality [ 17 ].…”

Section: Discussionsupporting

confidence: 92%

Acinetobacter baumannii Bloodstream Infections in the COVID-19 Era: A Comparative Analysis between COVID-19 and Non-COVID-19 Critically Ill Patients

et al. 2023

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The coronavirus disease (COVID-19) pandemic increased the incidence of severe infections caused by multidrug-resistant (MDR) pathogens among critically ill patients, such as Acinetobacter baumannii (AB), whose bloodstream infections (BSIs) have been associated with significant mortality. Whether there is any difference in outcome between COVID-19 and non-COVID-19 patients with AB BSI still remains unknown. We conducted a retrospective study comparing clinical characteristics and outcomes of COVID-19 versus non-COVID-19 critically ill patients with AB BSI. Overall, 133 patients with AB BSI (102 COVID-19, 31 non-COVID-19) were studied. The 28-day mortality rate was high and did not differ significantly (69.6% COVID-19 vs. 61.3% non-COVID-19, p = 0.275). Patients with septic shock had a higher mortality rate irrespective of their status with the majority of deaths occurring during the first 7 days. COVID-19 patients were more likely to have ventilator-associated pneumonia (VAP) as the source of BSI (55.8% vs. 22.3%, respectively, p = 0.0001) and were more likely to develop acute respiratory distress syndrome (ARDS) (78.4% vs. 48.4%, respectively, p = 0.001), sepsis (86.3% vs. 67.7%, respectively, p = 0.03), and septic shock (88.3% vs. 58.1%, respectively, p = 0.007) compared to the non-COVID-19 patient group. In conclusion, COVID-19 patients with A. baumannii BSI have a high rate of mortality and more often develop septic shock, while VAP is the main origin of their BSI.

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Section: Discussionsupporting

confidence: 92%

Acinetobacter baumannii Bloodstream Infections in the COVID-19 Era: A Comparative Analysis between COVID-19 and Non-COVID-19 Critically Ill Patients

et al. 2023

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“…Similarly, 50% of K. pneumoniae isolates were MDR, while only 31% of isolates of E. coli resulted in MDR [ 8 , 11 ]. Similarly, in a recent retrospective study, Gajic et al observed a high rate of K. pneumoniae and A. baumannii , which together accounted for 47 and 75.8% of the most common types of bloodstream and respiratory tract infections, respectively [ 20 ]. Another Italian paper by Tiri et al underscored a tight connection between COVID-19 and an increase in CRE colonization and infection in ICU.…”

Section: Discussionmentioning

confidence: 98%

Impact of the COVID-19 Pandemic on Epidemiology of Antibiotic Resistance in an Intensive Care Unit (ICU): The Experience of a North-West Italian Center

et al. 2023

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The SARS-CoV-2 pandemic caused an increase in intensive care unit (ICU) hospitalizations with a rise in morbidity and mortality; nevertheless, there is still little evidence on the impact of the pandemic on antibiotic resistance in ICUs. This is a retrospective, monocentric epidemiological study. The aim of the study was to describe and analyze the impact of the SARS-CoV-2 pandemic on ICU bacterial resistance patterns. All bacteria isolated from all patients admitted to the E.O. Galliera ICU from January 2018 to December 2022 were included. Antibiotic resistance (AR) profiles were evaluated. A total of 1021 microorganisms were identified, of which 221 (12.47%) had a resistance pattern (resistant organisms; ROs). In this time, there were 1679 patients with a total of 12,030 hospitalization days. The majority of microorganisms were Gram-negative (79.66% in 2018, 77.29% in 2019, 61.83% in 2020, 62.56% in 2021, and 60.75% in 2022), but an increase in Gram-positive microorganisms was observed (20.34 to 39.25% between 2018 and 2022). The prevalence of AR was 19.44% in 2018, 11.54% in 2019, 38.04% in 2020, 34.15% in 2021, and 39.29% in 2022 for Gram-positive microorganisms and 19.86% in 2018, 13.56% in 2019, 18.12% in 2020, 12.41% in 2021, and 12.31% in 2012 for Gram-negative microorganisms. The incidence of ROs showed a COVID-19-related increase in 2020–2021, followed by a lowering trend since 2021, and a new increase in 2022. Possible explanations are antibiotic overtreatment and a decrease in containment measures. An interesting finding was the cumulative lowering trend of carbapenem-resistant K. pneumoniae and P. aeruginosa, probably due to different patient features.

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“…In summary, antibiotic therapy has been compromised, and sometimes thwarted, by MDR pathogens. The reason is that the pathogens are resistant to either most or all antibiotics (reviews: [1][2][3][4][5][6][7][8][9][10]). The consequence is known to be lethal for roughly 48,000 citizens of the USA in 2019, when Clostridioides difficile (not typically pathogenic, but made pathogenic by long-term antibiotic use) is included [9,10].…”

Section: Introductionmentioning

confidence: 99%

Biophysical Breakthroughs Projected for the Phage Therapy of Bacterial Disease

Chambers,

Aldis,

Thomas

et al. 2024

Biophysica

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Past anti-bacterial use of bacteriophages (phage therapy) is already well reviewed as a potential therapeutic response to the emergence of multidrug-resistant, pathogenic bacteria. Phage therapy has been limited by the following. (1) The success rate is too low for routine use and Food and Drug Administration (FDA) approval. (2) Current strategies of routine phage characterization do not sufficiently improve the success rate of phage therapy. (3) The stability of many phages at ambient temperature is not high enough to routinely store and transport phages at ambient temperature. In the present communication, we present new and previous data that we interpret as introductory to biophysically and efficiently transforming phage therapy to the needed level of effectiveness. Included are (1) procedure and preliminary data for the use of native gel electrophoresis (a low-cost procedure) for projecting the therapy effectiveness of a newly isolated phage, (2) data that suggest a way to achieve stabilizing of dried, ambient-temperature phages via polymer embedding, and (3) data that suggest means to increase the blood persistence, and therefore the therapy effectiveness, of what would otherwise be a relatively low-persistence phage.

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The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study

Cited by 17 publications

References 28 publications

Acinetobacter baumannii Bloodstream Infections in the COVID-19 Era: A Comparative Analysis between COVID-19 and Non-COVID-19 Critically Ill Patients

Acinetobacter baumannii Bloodstream Infections in the COVID-19 Era: A Comparative Analysis between COVID-19 and Non-COVID-19 Critically Ill Patients

Impact of the COVID-19 Pandemic on Epidemiology of Antibiotic Resistance in an Intensive Care Unit (ICU): The Experience of a North-West Italian Center

Biophysical Breakthroughs Projected for the Phage Therapy of Bacterial Disease

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