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. 2021 Jan 3;9(1):95.
doi: 10.3390/microorganisms9010095.

Spread of Carbapenem-Resistant Gram-Negatives and Candida auris during the COVID-19 Pandemic in Critically Ill Patients: One Step Back in Antimicrobial Stewardship?

Laura Magnasco  1 , Malgorzata Mikulska  1   2 , Daniele Roberto Giacobbe  1   2 , Lucia Taramasso  1 , Antonio Vena  1 , Chiara Dentone  1 , Silvia Dettori  2 , Stefania Tutino  2 , Laura Labate  2 , Vincenzo Di Pilato  3 , Francesca Crea  4 , Erika Coppo  3   4 , Giulia Codda  3 , Chiara Robba  5 , Lorenzo Ball  3   5 , Nicolo' Patroniti  3   5 , Anna Marchese  3   4 , Paolo Pelosi  3   5 , Matteo Bassetti  1   2
Affiliations

Spread of Carbapenem-Resistant Gram-Negatives and Candida auris during the COVID-19 Pandemic in Critically Ill Patients: One Step Back in Antimicrobial Stewardship?

Laura Magnasco et al. Microorganisms. .

Abstract

The possible negative impact of severe adult respiratory distress caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection (COVID-19) on antimicrobial stewardship and infection control has been postulated, but few real-life data are available. The aim of this study was to report our experience with colonization/infection of carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Klebsiella pneumoniae (CR-Kp) and Candida auris among critically ill COVID-19 patients admitted to the intensive care unit (ICU). All COVID-19 patients admitted to the ICUs at San Martino Policlinico Hospital-IRCCS in Genoa, Italy, were screened from 28 February to 31 May 2020. One-hundred and eighteen patients admitted to COVID-19 ICUs were included in the study. Among them, 12 (10.2%) became colonized/infected with CRPA, 6 (5.1%) with C. auris and 2 (1.6%) with CR-Kp. All patients with CRPA received prior treatment with meropenem, and in 11 (91.7%) infection was not preceded by colonization. Four patients (66.7%) developed C. auris candidemia. A significant spread of resistant pathogens was observed among critically ill COVID-19 patients. Dedicated strategies are warranted to prevent horizontal spread and maintain effective antimicrobial stewardship programs in the setting of COVID-19 care.

Keywords: Candida auris; Klebsiella pneumoniae; Pseudomonas aeruginosa; antimicrobial resistance; carbapenem-resistance; intensive care.

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Conflict of interest statement

Outside the submitted work, MM has received personal fees from Gilead, Pfizer, Merck, Biotest and Janssen; DRG reports honoraria from Stepstone Pharma GmbH and unconditional grants from MSD Italia and Correvio Italia; MB has participated in advisory boards and/or received speaker honoraria from Achaogen, Angelini, Astellas, Bayer, Basilea, BioMérieux, Cidara, Gilead, Menarini, MSD, Nabriva, Paratek, Pfizer, Roche, Melinta, Shionogi, Tetraphase, VenatoRx and Vifor and has received study grants from Angelini, Basilea, Astellas, Shionogi, Cidara, Melinta, Gilead, Pfizer and MSD. The other authors have no conflicts of interest to disclose.

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