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Impact of the COVID-19 Pandemic on CLABSI Rates and Antibiotic Resistance: A Multicenter Study in Türkiye
Elif Sargın-Altunok1, Şiran Keske2, Ayşe Batırel1
1Departmen of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye.
Insights
The COVID-19 pandemic saw a decrease in central line-associated bloodstream infections (CLABSI) rates in Türkiye, but increased mortality. Predominant pathogens remained consistent, though antibiotic resistance rose.
Area of Science:
- Healthcare-associated infections
- Epidemiology
- Infectious diseases
Background:
- The COVID-19 pandemic significantly disrupted healthcare, potentially impacting infection control.
- Previous research indicated rising central line-associated bloodstream infections (CLABSI) during the pandemic.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on CLABSI rates in Türkiye from 2019 to 2022.
- To analyze changes in causative pathogens and antibiotic resistance patterns.
Main Methods:
- Retrospective analysis of prospectively collected CLABSI data from 25 Turkish hospitals (2019-2022).
- Data divided into pre-pandemic, early pandemic, and late pandemic phases.
- Analysis included demographic, clinical, microbiological data, mortality rates, pathogen distribution, and antibiotic resistance.
Main Results:
- CLABSI rates per 1000 catheter days decreased from 4.26 in 2019 to 3.53 in 2022.
- Gram-negative bacteria, particularly Acinetobacter baumannii and Klebsiella pneumoniae, were the most common pathogens.
- An increase in carbapenem and colistin resistance in K. pneumoniae was observed during the pandemic.
Conclusions:
- The primary pathogens causing CLABSI in Türkiye remained consistent during the pandemic.
- Despite a decrease in CLABSI rates, increased mortality associated with these infections was noted, underscoring healthcare system strain.
Objective:
The COVID-19 pandemic significantly disrupted infection control practices in healthcare settings. Previous studies have reported increased rates of central line-associated bloodstream infections (CLABSI), particularly during the early stages and peak periods of the pandemic. This multicenter study aimed to evaluate the impact of the COVID-19 pandemic on CLABSI rates in Türkiye over a four-year period from 2019 to 2022.
Materials And Methods:
We conducted a retrospective analysis of prospectively collected CLABSI data from hospitals across various regions of Türkiye between 2019 and 2022. The study period was divided into three phases: pre-pandemic, early pandemic, and late pandemic. Demographic and clinical characteristics, mortality rates, and microbiological data were analyzed. Pathogen distribution and antibiotic resistance patterns were compared between the pre-pandemic and pandemic periods.
Results:
A total of 25 hospitals participated in the study. The CLABSI rates per 1000 catheter days were 4.26 in 2019, 4.13 in 2020, 3.68 in 2021, and 3.53 in 2022. Across all periods, 3238 pathogens were identified. Gram-negative bacteria predominated both before and during the pandemic, with Acinetobacter baumannii (18.6%) and Klebsiella pneumoniae (17.8%) being the most common. Notably, an increase in carbapenem and colistin resistance in K. pneumonia was observed during the pandemic compared to the pre-pandemic period.
Conclusions:
In Türkiye, the predominant causative agents of CLABSI did not change during the pandemic, with Klebsiella spp. and A. baumannii being most frequently isolated. However, the rise in CLABSI-associated mortality during the pandemic highlights the broader impact of healthcare system disruptions.
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