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Observational Study
. 2022 Jan;50(1):32-38.
doi: 10.1016/j.ajic.2021.09.018. Epub 2021 Sep 23.

Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil

Matheus Polly  1 , Bianca L de Almeida  2 , Robert P Lennon  3 , Marina Farrel Cortês  4 , Silvia F Costa  5 , Thais Guimarães  2
Affiliations
Observational Study

Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil

Matheus Polly et al. Am J Infect Control. 2022 Jan.

Abstract

Background: The impact of COVID-19 on healthcare- associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria that contribute to higher mortality is a growing area of study METHODS: This retrospective observational study compares the incidence density (ID) of HCAI caused by MDR bacteria (CRE, CRAB, CRP, MRSA and VRE) pre-COVID (2017-2019) and during the COVID-19 pandemic (2020) in overall hospitalized patients and in intensive care (ICU) units.

Results: We identified 8,869 HCAI, of which 2,641 (29.7%) were caused by bacterial MDR, and 1,257 (14.1%) were from ICUs. The overall ID of MDR infections increased 23% (P < .005) during COVID-19. The overall per-pathogen analysis shows significant increases in infections by CRAB and MRSA (+108.1%, p&lt;0.005; +94.7%, p&lt;0.005, respectively), but not in CRE, CRP, or VRE. In the ICU, the overall ID of MDR infections decreased during COVID, but that decline was not significant (-6.5%, P = .26). The ICU per-pathogen analysis of ID of infection showed significant increases in CRAB and MRSA (+42.0%, P = .001; +46.2%, P = .04), significant decreases in CRE and CRP (-26.4%, P = .002; -44.2%, P = 0.003, respectively) and no change in VRE.

Conclusions: The COVID-19 pandemic correlates to an increase in ID of CRAB and MRSA both in ICU and non-ICU setting, and a decrease in ID of CRE and CRP in the ICU setting. Infection control teams should be aware of possible outbreaks of CRAB and MRSA and promote rigorous adherence to infection control measures as practices change to accommodate changes in healthcare needs during and after the pandemic.

Keywords: Carbapenem-resistant Acinetobacter baumannii infection; Epidemiology; Healthcare-associated infections; Methicillin-resistant Staphylococcus aureus infection; Multidrug resistant bacteria; Multidrug resistant infection.

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Figures

Fig 1
Fig 1
Healthcare associated infection (HCAI) database selection diagram.
Fig 2
Fig 2
Incidence densities for MDR infections in pre-pandemic and pandemic period.
Fig 3
Fig 3
Distribution of Incidence densities of Gram negative MDR - CRE, CRAB and CRP – infections (A = overall; B = ICU).
Fig 4
Fig 4
Distribution of incidence densities of Gram positive MDR - MRSA and VRE – infections (A = overall; B = ICU).
See this image and copyright information in PMC

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