Julian E Grass, Sandra N Bulens, Uzma A Ansari, Nadezhda Duffy, Jesse T Jacob, Gillian Smith, Paulina A Rebolledo, Ana Mesa Restrepo, Elisabeth Vaeth, Ghinwa Dumyati, Rebecca Tsay, Hsioa Che Looi, Erin Phipps, Kristina G Flores, Christopher Wilson, Daniel Muleta, Christopher A Czaja, Jennifer Driscoll, Helen Johnston, Ruth Lynfield, Sean O'Malley, Meghan Maloney, Nicole Stabach, Joelle Nadle, Rebecca Pierce, Heather Hertzel, Alice Y Guh
{"title":"2020- 2022年，美国10个地点，一项确定耐多药肠杆菌感染住院患者中COVID-19患病率和临床结果的观察性研究","authors":"Julian E Grass, Sandra N Bulens, Uzma A Ansari, Nadezhda Duffy, Jesse T Jacob, Gillian Smith, Paulina A Rebolledo, Ana Mesa Restrepo, Elisabeth Vaeth, Ghinwa Dumyati, Rebecca Tsay, Hsioa Che Looi, Erin Phipps, Kristina G Flores, Christopher Wilson, Daniel Muleta, Christopher A Czaja, Jennifer Driscoll, Helen Johnston, Ruth Lynfield, Sean O'Malley, Meghan Maloney, Nicole Stabach, Joelle Nadle, Rebecca Pierce, Heather Hertzel, Alice Y Guh","doi":"10.1093/ofid/ofae745","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022.</p><p><strong>Methods: </strong>We defined a CRE case as the first isolation of <i>Escherichia coli</i>, <i>Enterobacter cloacae</i> complex, <i>Klebsiella aerogenes</i>, <i>K oxytoca</i>, <i>K pneumoniae</i>, or <i>K variicola</i> resistant to any carbapenem. We defined an ESBL-E case as the first isolation of <i>E coli</i>, <i>K pneumoniae</i>, or <i>K oxytoca</i> resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2<sup>+</sup>) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses.</p><p><strong>Results: </strong>Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2.4%) and 60 (3.2%), respectively, had a SC2<sup>+</sup>. Among these cases, a SC2<sup>+</sup> was associated with intensive care unit admission (adjusted odds ratio [aOR], 1.69 [95% CI, 1.14-2.50]; aOR, 1.48 [95% CI, 1.03-2.12]) and 30-day mortality (aOR, 1.79 [95% CI, 1.22-2.64]; aOR, 1.94 [95% CI, 1.39-2.70]).</p><p><strong>Conclusions: </strong>CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae745"},"PeriodicalIF":3.8000,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736413/pdf/","citationCount":"0","resultStr":"{\"title\":\"An Observational Study to Determine the Prevalence of COVID-19 Among Hospitalized Patients With Multidrug-Resistant Enterobacterales Infections and Clinical Outcomes, 10 US Sites, 2020--2022.\",\"authors\":\"Julian E Grass, Sandra N Bulens, Uzma A Ansari, Nadezhda Duffy, Jesse T Jacob, Gillian Smith, Paulina A Rebolledo, Ana Mesa Restrepo, Elisabeth Vaeth, Ghinwa Dumyati, Rebecca Tsay, Hsioa Che Looi, Erin Phipps, Kristina G Flores, Christopher Wilson, Daniel Muleta, Christopher A Czaja, Jennifer Driscoll, Helen Johnston, Ruth Lynfield, Sean O'Malley, Meghan Maloney, Nicole Stabach, Joelle Nadle, Rebecca Pierce, Heather Hertzel, Alice Y Guh\",\"doi\":\"10.1093/ofid/ofae745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022.</p><p><strong>Methods: </strong>We defined a CRE case as the first isolation of <i>Escherichia coli</i>, <i>Enterobacter cloacae</i> complex, <i>Klebsiella aerogenes</i>, <i>K oxytoca</i>, <i>K pneumoniae</i>, or <i>K variicola</i> resistant to any carbapenem. We defined an ESBL-E case as the first isolation of <i>E coli</i>, <i>K pneumoniae</i>, or <i>K oxytoca</i> resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2<sup>+</sup>) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses.</p><p><strong>Results: </strong>Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2.4%) and 60 (3.2%), respectively, had a SC2<sup>+</sup>. Among these cases, a SC2<sup>+</sup> was associated with intensive care unit admission (adjusted odds ratio [aOR], 1.69 [95% CI, 1.14-2.50]; aOR, 1.48 [95% CI, 1.03-2.12]) and 30-day mortality (aOR, 1.79 [95% CI, 1.22-2.64]; aOR, 1.94 [95% CI, 1.39-2.70]).</p><p><strong>Conclusions: </strong>CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19.</p>\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":\"12 1\",\"pages\":\"ofae745\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-12-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736413/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae745\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae745","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
An Observational Study to Determine the Prevalence of COVID-19 Among Hospitalized Patients With Multidrug-Resistant Enterobacterales Infections and Clinical Outcomes, 10 US Sites, 2020--2022.
Background: We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022.
Methods: We defined a CRE case as the first isolation of Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes, K oxytoca, K pneumoniae, or K variicola resistant to any carbapenem. We defined an ESBL-E case as the first isolation of E coli, K pneumoniae, or K oxytoca resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2+) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses.
Results: Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2.4%) and 60 (3.2%), respectively, had a SC2+. Among these cases, a SC2+ was associated with intensive care unit admission (adjusted odds ratio [aOR], 1.69 [95% CI, 1.14-2.50]; aOR, 1.48 [95% CI, 1.03-2.12]) and 30-day mortality (aOR, 1.79 [95% CI, 1.22-2.64]; aOR, 1.94 [95% CI, 1.39-2.70]).
Conclusions: CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19.
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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