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Healthcare-Associated Infections Secondary to Multidrug-Resistant Organisms in Hospitalised Patients with COVID-19
Yahyia Al Hanashi1, Abdullah Balkhair2
1Internal Medicine Program, Oman Medical Specialty Board, Muscat, Oman.
Objectives:
Hospitalisations related to COVID-19 pneumonia have increased the risk of healthcare-associated infections (HCAIs), including those caused by multidrug-resistant organisms (MDROs). This study aimed to investigate the epidemiology of HCAIs secondary to MDROs among hospitalised patients with COVID-19 pneumonia.
Methods:
This retrospective study population included patients with COVID-19 pneumonia aged 18 years and older who were admitted to Sultan Qaboos University Hospital, Muscat, Oman, for more than 48 hours between March 2020 and December 2021.
Results:
A total of 486 patients were included in this study. Among the cohort, 76 patients (15.6%) were diagnosed with concurrent HCAIs with an MDRO as the causative pathogen. Of these patients, 31 (40.8%) had infections caused by MDR Acinetobacter baumannii, 15 (19.7%) had infections secondary to carbapenem-resistant Klebsiella pneumoniae and 8 (10.5%) had infections caused by extended-spectrum betalactamase Escherichia coli. Pneumonia and bacteraemia were the two most common concurrent healthcare-associated MDRO infection sites, accounting for 42% and 36% of all events, respectively. Among the 486 patients, 155 died (31.9%). Among these, 64 (41.3%) had concurrent HCAIs caused by 1 or more MDROs. Contrarily, among the 331 patients with COVID-19 pneumonia who recovered, only 12 (3.6%) had concurrent HCAIs.
Conclusions:
There is high prevalence of healthcare-associated MDRO infections.predominantly pneumonia and bacteraemia.in hospitalised patients with COVID-19 pneumonia. This reveals a significant association between infection with MDROs and death underlining the substantial impact of infection with MDROs in this vulnerable patient population.
Insights
Healthcare-associated infections (HAIs) with multidrug-resistant organisms (MDROs) are prevalent in COVID-19 pneumonia patients. These infections, particularly pneumonia and bacteraemia, significantly increase mortality risk in this vulnerable group.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Hospitalizations for COVID-19 pneumonia have led to increased healthcare-associated infections (HAIs).
- Multidrug-resistant organisms (MDROs) pose a significant threat in hospital settings, especially among vulnerable patient populations.
- Understanding the epidemiology of MDROs in COVID-19 patients is crucial for effective infection control.
Purpose of the Study:
- To investigate the epidemiology of healthcare-associated infections (HAIs) caused by multidrug-resistant organisms (MDROs).
- To determine the prevalence and types of MDROs in hospitalized patients with COVID-19 pneumonia.
- To assess the impact of MDRO infections on mortality in COVID-19 patients.
Main Methods:
- Retrospective study conducted at Sultan Qaboos University Hospital, Muscat, Oman.
- Inclusion criteria: patients aged 18+ with COVID-19 pneumonia admitted for >48 hours.
- Data collected between March 2020 and December 2021.
Main Results:
- Out of 486 patients, 76 (15.6%) developed concurrent HAIs with MDROs.
- Most common MDROs included MDR Acinetobacter baumannii (40.8%), carbapenem-resistant Klebsiella pneumoniae (19.7%), and ESBL Escherichia coli (10.5%).
- Pneumonia (42%) and bacteraemia (36%) were the most frequent HAI sites. MDRO infections were present in 41.3% of deceased patients versus 3.6% of survivors.
Conclusions:
- Healthcare-associated MDRO infections, primarily pneumonia and bacteraemia, are highly prevalent in hospitalized COVID-19 pneumonia patients.
- Infection with MDROs is significantly associated with increased mortality.
- These findings highlight the substantial impact of MDROs on this vulnerable patient population.
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