Epidemiology of multidrug-resistant organisms before and during COVID-19 in Hong Kong.

Autor:	Wong SC; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China., Chau PH; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China., So SY; Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Chiu KH; Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Yuen LL; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China., AuYeung CH; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China., Lam GK; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China., Chan VW; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China., Chen JH; Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Chen H; Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China., Li X; Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China., Ho PL; Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China., Chan SS; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China., Yuen KY; Carol Yu Center for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China., Cheng VC; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.; Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
Jazyk:	angličtina
Zdroj:	Infection prevention in practice [Infect Prev Pract] 2023 Jun; Vol. 5 (2), pp. 100286. Date of Electronic Publication: 2023 May 08.
DOI:	10.1016/j.infpip.2023.100286
Abstrakt:	Background: The coronavirus disease 2019 (COVID-19) has influenced antimicrobial consumption and incidence of multidrug-resistant organisms (MDROs). We aimed to study the epidemiology of MDROs before and during the COVID-19 pandemic in Hong Kong. Methods: With the maintenance of infection control measures, we described the trend of MDRO infections, including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum-beta-lactamase-(ESBL)-producing Enterobacterales, in a healthcare region with 3100-bed before (1 January 2016 to 31 December 2019, period 1) and during COVID-19 (1 January 2020 to 30 September 2022, period 2), together with the antimicrobial consumption using piecewise Poisson regression. The epidemiological characteristics of newly diagnosed COVID-19 patients with or without MDRO infections were analyzed. Results: Between period 1 and 2, we observed a significant increase in the trend of CRA infections ( P <0.001), while there was no significant increase in the trend of MRSA ( P =0.742) and ESBL-producing Enterobacterales ( P =0.061) infections. Meanwhile, a significant increase in the trend of carbapenems ( P <0.001), extended-spectrum beta-lactam-beta-lactamase inhibitor combinations (BLBI) ( P =0.045), and fluoroquinolones ( P =0.009) consumption was observed. The observed opportunity (23,540 ± 3703 vs 26,145 ± 2838, p =0.359) and compliance (81.6% ± 0.5% vs 80.1% ± 0.8%, P =0.209) of hand hygiene per year was maintained. In a multivariable model, older age, male sex, referral from residential care home for the elderly, presence of indwelling device, presence of endotracheal tube, and use of carbapenems, use of BLBI, use of proton pump inhibitors and history of hospitalization in the past 3 months were associated with higher risks of infections by MDROs among COVID-19 patients. Conclusion: Infection control measures may control the surge of MDROs despite an increasing trend of antimicrobial consumption. (© 2023 The Authors.)
Databáze:	MEDLINE
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