Impact of COVID-19 Pandemic on carbapenem-resistant Enterobacteriaceae bloodstream infection: a single-center study in China.

Abstract

Introduction: The problem of carbapenem resistance in Enterobacteriaceae is becoming increasingly serious, and Carbapenem-Resistant Enterobacteriaceae (CRE) has become a major problem in clinical infection, especially in intensive care units (ICU). The purpose of the study is to explore the impact of the occurrence of COVID-19 on the bloodstream infection of CRE (CRE-BSI) and carbapenem resistance.

Methodology: In this study, adult patients with CRE-BSI from January 2019 to January 2023 were collected to perform a single-center cross-sectional study, who were divided into pre-COVID-19, COVID-19 until "New Ten" (only accept non-COVID-19 patients), and post-"New Ten" group (accept COVID-19 and non-COVID-19 patients), according to the epidemic prevention and control policy.

Results: Among 184 CRE-BSI cases confirmed during pre-COVID-19, COVID-19 until "New Ten" and post-"New Ten" periods, the CRE-BSI rates were 7.81, 8.13, and 9.63 cases per 100,000 hospitalization days. Correspondingly, the carbapenem resistance rates in Enterobacteriaceae were 18.6%,16.4%, and 19.0%, respectively, although no significant statistical differences were noted between the examined periods. The intensity of antimicrobial use increased significantly (p < 0.001) after the outbreak of the epidemic, and even increased to 1.5 times after the implementation of the "New Ten" compared to the pre-COVID-19 period. Notably, the utilization of third- and fourth-generation cephalosporins experienced a significant increase in CRE-BSI patients during the COVID-19 epidemic (p = 0.013).

Conclusions: During the epidemic, an increased broad-spectrum antimicrobial use happened in CRE-BSI patients.