Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic
Open Access
- 11 February 2021
- journal article
- research article
- Published by MDPI AG in Antibiotics
- Vol. 10 (2), 182
- https://doi.org/10.3390/antibiotics10020182
Abstract
Objective: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. Methods: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. Results: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05). Conclusion: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively.Keywords
This publication has 33 references indexed in Scilit:
- European intensive care physicians’ experience of infections due to antibiotic-resistant bacteriaAntimicrobial Resistance & Infection Control, 2020
- Epidemiology and Treatment of Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa InfectionsClinical Microbiology Reviews, 2019
- Mechanisms of antimicrobial-induced nephrotoxicity in childrenJournal of Antimicrobial Chemotherapy, 2019
- The frequency of influenza and bacterial coinfection: a systematic review and meta‐analysisInfluenza and Other Respiratory Viruses, 2016
- Critically Ill Patients With 2009 Influenza A(H1N1) in MexicoJAMA, 2009
- AmpC β-LactamasesClinical Microbiology Reviews, 2009
- Cluster-Randomized Trial to Improve Antibiotic Use for Adults With Acute Respiratory Infections Treated in Emergency DepartmentsAnnals of Emergency Medicine, 2007
- Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods.2001
- Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: Background, specific aims, and methodsAnnals of Emergency Medicine, 2001