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Reduction of Multidrug-Resistant (MDR) Bacterial Infections during the COVID-19 Pandemic: A Retrospective Study
Enrico Bentivegna1, Michelangelo Luciani1, Luca Arcari2
1Internal Medicine and Emergency Medicine, St'Andrea Hospital, Sapienza University, 00189 Rome, Italy.
Abstract:
Multidrug-resistant (MDR) organisms are emerging as some of the main healthcare problems worldwide. During the COVID-19 pandemic, several Infection Prevention and Control (IPC) measures have been adopted to reduce nosocomial microorganism transmission. We performed a case-control study to identify if the incidence of MDR bacterial infections while using pandemic-related preventive measures is lower than in previous years. From 2017 to 2020, we monitored hospital discharges over a four-month period (P #) (1 March to 30 June) in St. Andrea Hospital, Rome. In total, we reported 1617 discharges. Pearson's chi-squared test was used to identify significant differences. A value of p ≤ 0.05 was considered statistically significant. A significant reduction in the incidence of total MDR bacterial infections was observed during the pandemic compared to in prepandemic years (p < 0.05). We also found a significantly higher incidence of MDR bacterial infections in COVID-19 departments compared with other medical departments (29% and 19%, respectively), with extended-spectrum β-lactamase Klebsiella pneumoniae as the pathogens presenting the highest increase. This study demonstrates that maintaining a high level of preventive measures could help tackle an important health problem such as that of the spread of MDR bacteria.
Insights
Pandemic-related infection control measures significantly reduced multidrug-resistant (MDR) bacterial infections. However, COVID-19 wards saw higher MDR rates, particularly extended-spectrum beta-lactamase Klebsiella pneumoniae.
Area of Science:
- Healthcare epidemiology
- Infectious disease control
- Antimicrobial resistance
Background:
- Multidrug-resistant (MDR) organisms pose a significant global healthcare challenge.
- The COVID-19 pandemic prompted widespread adoption of Infection Prevention and Control (IPC) measures.
- The impact of these enhanced IPC measures on MDR bacterial infections required investigation.
Purpose of the Study:
- To assess if pandemic-era IPC measures reduced the incidence of MDR bacterial infections compared to prepandemic periods.
- To identify specific trends in MDR infections during the COVID-19 pandemic.
- To compare MDR infection rates between COVID-19 and non-COVID-19 hospital departments.
Main Methods:
- A case-control study design was employed.
- Hospital discharge data from March 1 to June 30 between 2017 and 2020 were analyzed (total 1617 discharges).
- Pearson's chi-squared test was used to determine statistical significance (p ≤ 0.05).
Main Results:
- A statistically significant reduction in overall MDR bacterial infections was observed during the pandemic period compared to prepandemic years (p < 0.05).
- MDR bacterial infections were significantly higher in COVID-19 departments (29%) compared to other medical departments (19%).
- Extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae showed the most substantial increase in incidence.
Conclusions:
- Enhanced IPC measures implemented during the COVID-19 pandemic were associated with a reduction in overall MDR bacterial infections.
- Despite overall reductions, specific departments like COVID-19 wards experienced higher MDR burdens.
- Sustaining rigorous preventive measures is crucial for combating the spread of MDR bacteria.
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