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Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

2021; Multidisciplinary Digital Publishing Institute; Volume: 10; Issue: 2 Linguagem: Inglês

10.3390/antibiotics10020182

2079-6382

Bernardo Alfonso Martínez-Guerra, María Fernanda González-Lara, Nereyda A. de-León-Cividanes, Karla M. Tamez‐Torres, Carla Marina Román-Montes, Sandra Rajme‐López, G. Ivonne Villalobos-Zapata, Norma Irene López-García, Areli Martínez‐Gamboa, José Sifuentes‐Osornio, Edgar Ortíz‐Brizuela, Eric Ochoa‐Hein, Arturo Galindo‐Fraga, Miriam Bobadilla-del-Valle, Alfredo Ponce‐de‐León,

Nosocomial Infections in ICU

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.