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. 2022 Jan:114:90-96.
doi: 10.1016/j.ijid.2021.10.034. Epub 2021 Oct 22.

Surging bloodstream infections and antimicrobial resistance during the first wave of COVID-19: a study in a large multihospital institution in the Paris region

Rishma Amarsy  1 , David Trystram  2 , Emmanuelle Cambau  3 , Catherine Monteil  4 , Sandra Fournier  4 , Juliette Oliary  5 , Helga Junot  6 , Pierre Sabatier  7 , Raphaël Porcher  8 , Jérôme Robert  9 , Vincent Jarlier  10 ; “la Collégiale de Bactériologie–Virologie–Hygiène de l'Assistance Publique – Hôpitaux de Paris”
Collaborators, Affiliations

Surging bloodstream infections and antimicrobial resistance during the first wave of COVID-19: a study in a large multihospital institution in the Paris region

Rishma Amarsy et al. Int J Infect Dis. 2022 Jan.

Abstract

Objectives: This study measured the impact of the first wave of COVID-19 pandemic (COVID-19) (March-April 2020) on the incidence of bloodstream infections (BSIs) at Assistance Publique - Hôpitaux de Paris (APHP), the largest multisite public healthcare institution in France.

Methods: The number of patient admission blood cultures (BCs) collected, number of positive BCs, and antibiotic resistance and consumption were analysed retrospectively for the first quarter of 2020, and also for the first quarter of 2019 for comparison, in 25 APHP hospitals (ca. 14 000 beds).

Results: Up to a fourth of patients admitted in March-April 2020 in these hospitals had COVID-19. The BSI rate per 100 admissions increased overall by 24% in March 2020 and 115% in April 2020, and separately for the major pathogens (Escherichia coli, Klebsiella pneumoniae, enterococci, Staphylococcus aureus, Pseudomonas aeruginosa, yeasts). A sharp increase in the rate of BSIs caused by microorganisms resistant to third-generation cephalosporins (3GC) was also observed in March-April 2020, particularly in K. pneumoniae, enterobacterial species naturally producing inducible AmpC (Enterobacter cloacae...), and P. aeruginosa. A concomitant increase in 3GC consumption occurred.

Conclusions: The COVID-19 pandemic had a strong impact on hospital management and also unfavourable effects on severe infections, antimicrobial resistance, and laboratory work diagnostics.

Keywords: Antibiotic consumption; Antimicrobial resistance; Blood culture; Bloodstream infection incidence; COVID-19.

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Figures

Figure 1
Figure 1
Change in the number of patients with COVID-19 presenting daily during March and April 2020 at Assistance Publique – Hôpitaux de Paris (APHP).
Figure 2
Figure 2
Rate ratios of blood cultures collected (BC), positive blood cultures (BC+), and bloodstream infections (BSI) per 100 admissions in March and April 2020 compared to expected values; 99% confidence intervals are provided.
Figure 3
Figure 3
Monthly consumption of third-generation cephalosporins, expressed as the defined daily dose (DDD) per 100 admissions, during the first 4 months of the years 2019 and 2020 in the 25 hospitals of Assistance Publique – Hôpitaux de Paris (APHP).
See this image and copyright information in PMC

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