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Bloodstream Infections with Opportunistic Pathogens in COVID-19 Era: A Real Challenge Necessitates Stringent
Partha Guchhait1, Bhaskar Narayan Chaudhuri1, Satadal Das1
1Department of Microbiology, Peerless Hospitex Hospital and Research Center Ltd., Kolkata, West Bengal, India.
Insights
Implementing strict infection control measures significantly reduced bloodstream infections (BSI) from opportunistic pathogens in hospitalized patients. Identifying environmental sources and risk factors like prolonged ICU stays is crucial for mitigating BSI during pandemics.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Bloodstream infections (BSI) caused by opportunistic pathogens pose a significant threat to hospitalized patients, particularly during the coronavirus disease 2019 (COVID-19) pandemic.
- Understanding the risk factors and effective control strategies for BSI is critical for improving patient outcomes and reducing mortality.
Purpose of the Study:
- To identify key risk factors associated with BSI caused by opportunistic pathogens.
- To evaluate the effectiveness of a rigorous infection control program in mitigating BSI.
Main Methods:
- A 6-month prospective, cross-sectional study involving 150 patients in COVID-19 and non-COVID-19 intensive care units.
- Bloodstream infections were confirmed using BACTEC and Vitek 2 compact systems.
- Prospective surveillance, environmental sampling for source tracking, and implementation of strict infection control measures were conducted.
Main Results:
- Common opportunistic pathogens identified include *Burkholderia cepacia*, *Elizabethkingia meningoseptica*, *Candida auris*, vancomycin-resistant *Enterococcus*, and *Achromobacter xylosoxidans*.
- Major risk factors identified were prolonged intensive care unit (ICU) stay, central venous access, mechanical ventilation, immunosuppression, and biologic use.
- Reverse osmosis water and used normal saline bottles were identified as common environmental sources.
- Implementation of precise infection control measures led to a significant reduction in BSI cases.
Conclusions:
- Combined prospective surveillance and environmental sampling are effective in identifying sources of opportunistic pathogens.
- An intensive and persistent infection control program is essential for controlling opportunistic pathogen-mediated BSI in healthcare settings.
Abstract:
Background : Bloodstream infections (BSI) due to opportunistic microbes in the coronavirus disease 2019 (COVID-19) pandemic lead to high morbidity and mortality among hospitalized patients. Thus, it is vital to find out the risk factors of BSI and to learn the ways to mitigate it. Aim : The aim of this study was to evaluate important risk factors of BSI due to opportunistic pathogens and to assess the role of the rigid infection control program to deal with this issue. Methods : A prospective, cross-sectional study was performed for 6 months on 150 patients admitted in both COVID-19 and non-COVID-19 intensive care units of our hospital. BSI was confirmed by the BACTEC and Vitek 2 compact system. Prospective surveillance and environmental sampling were carried out for source tracking along with rigorous infection control measures and the outcome was analyzed. Findings : Burkholderia cepacia, Elizabethkingia meningoseptica, Candida auris, vancomycin-resistant Enterococcus , and Achromobacter xylosoxidans were the common opportunistic pathogens isolated from a single or paired blood sample(s) in our study. Key risk factors were prolonged intensive care unit stay, central venous access, mechanical ventilation, immune-compromised condition, and use of biologics. Reverse osmosis water and used normal saline bottles were the common environmental source of infection. Following the implementation of precise infection control measures, there was a sharp decline in BSI cases, which was not attributed to the downfall of COVID-19 cases. Conclusion : Combined prospective surveillance and environmental sampling helped to find out the sources and implementation of an intensive and insistent infection control program that are needed to control opportunistic pathogens mediated BSI.
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