| Autor: |
Sarah B. Nahhal, MD, Johnny Zakhour, MD, Abdel Hadi Shmoury, MD, Tedy Sawma, MD, Sara F. Haddad, MD, Tamara Abdallah, MSc, Nada Kara Zahreddine, CIC, Joseph Tannous, MHRM, Nisrine Haddad, Pharm D, Nesrine Rizk, MD, Souha S. Kanj, MD |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 7, Iss 6, Pp 556-568 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2542-4548 |
| DOI: |
10.1016/j.mayocpiqo.2023.10.001 |
| Popis: |
Objective: To report the microbiological profile of the pathogens implicated in blood stream infections (BSI) in hospitalized coronavirus disease 2019 (COVID-19) patients and to examine the risk factors associated with multidrug-resistant organisms (MDROs) causing BSI. Patients and Methods: Between March 2020 and September 2021, 1647 patients were hospitalized with COVID-19 at the American University of Beirut. From 85 patients, 299 positive blood cultures were reported to the Infection Control and Prevention Program. The BSI was defined as 1 positive blood culture for bacterial or fungal pathogens. The following organisms were considered MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp, carbapenem-resistant Enterobacterales spp., carbapenem-resistant Pseudomonas aeruginosa, MDR Acinetobacter baumannii only susceptible to colistin or tigecycline, and Candida auris. Results: We identified 99 true positive BSI events. Gram-negative bacteria accounted for 38.4 %, followed by Gram-positive bacteria (37.4%), and fungi (24.2%). The most isolated species were Candida spp. (23%), 3 of which were C. auris, followed by Enterobacterales spp. (13%), Enterococcus spp. (12%), S. aureus (9%), P. aeruginosa (9%), and A. baumannii (3%). The MDROs represented 26% of the events. The overall mortality rate was 78%. The time to acquisition of BSI in patients with MDROs was significantly longer compared with that of non-MDROs (20.2 days vs 11.2 days). And there was a significantly shorter time from acquisition of BSI to mortality between MDROs and non-MDROs (1.5 vs 8.3 days). Conclusion: Rigorous infection prevention and control measures and antimicrobial stewardship are important to prevent antimicrobial resistance progression, especially in low-resource settings. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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