COVID-19国家卫生警报对智利肠杆菌科医院疫情的影响

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-03-22 DOI:10.1016/j.jhin.2025.03.003

C. Lara , M. Orsini , M. Pohlenz , K. Ulloa , I. Castro , C. Muñoz-Almagro , P. Brotons

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引用次数: 0

摘要

背景：针对COVID-19大流行的公共卫生干预措施对医院肠杆菌科暴发发生的影响尚不清楚。目的：了解2019冠状病毒病国家卫生警报对智利公立医院肠杆菌科疫情长期趋势的影响，并分析其抗生素耐药性模式。方法：在全国范围内进行回顾性生态学研究，对三个时期(大流行前（2017年1月- 2020年2月）、健康预警（2020年3月- 2023年8月）和大流行后（2023年9月- 12月）的每月暴发相关病例进行中断时间序列分析。结果：47/196（24.0%）家医院共发现106例暴发，1131例相关病例，254例死亡。病例数逐渐增加(0.39例/月，95% CI 0.02-0.75；P =0.040)。突然上升33.42例(95% CI 7.53 ~ 59.31例；p=0.012)，随后逐渐减少(1.28例/月，95% CI 0.38-2.17；P =0.006)。反弹18.02例(95% CI 2.89-33.15；p=0.020)发生在2023年9月，并且在大流行后逐渐下降之前(6.21例/月，95% CI 1.11-11.31；p = 0.018)。结论：2019冠状病毒病国家卫生警报与智利公立医院肠杆菌科暴发相关病例的长期趋势发生显著变化相关，包括在卫生警报开始和结束时突然增加，在此期间和之后逐渐下降。在大流行爆发后，观察到碳青霉烯酶产量急剧增加。

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Impact of the COVID-19 national health alert on Enterobacterales hospital outbreaks in Chile

Background

The impact of public health interventions against the coronavirus disease 2019 (COVID-19) pandemic on the occurrence of Enterobacterales outbreaks in hospitals remains unclear.

Objective

To determine the effect of the COVID-19 national health alert on the secular trend of Enterobacterales outbreaks in Chilean public hospitals while characterizing their antibiotic resistance patterns.

Methods

Nationwide retrospective ecological study using interrupted time series analysis of monthly outbreak-related cases over three periods: pre-pandemic (January 2017–February 2020), national health alert (March 2020–August 2023), and post-pandemic (September–December 2023).

Results

A total of 106 outbreaks, 1131 associated cases and 254 deaths were identified in 47/196 (24.0%) hospitals. Cases increased gradually [0.39 cases/month, 95% confidence interval (CI) 0.02–0.75; P=0.040] in the pre-pandemic years. A sudden increase of 33.42 cases (95% CI 7.53–59.31; P=0.012) occurred in March 2020, followed by a gradual decrease (1.28 cases/month, 95% CI 0.38–2.17; P=0.006) during the national health alert period. An increase of 18.02 cases (95% CI 2.89–33.15; P=0.020) occurred in September 2023, and preceded a gradual post-pandemic decline (6.21 cases/month, 95% CI 1.11–11.31; P=0.018). The prevalence of cases caused by carbapenemase-producing Enterobacterales increased significantly (P<0.001) during (79.9%) and after (100.0%) the national health alert period compared with the pre-pandemic period (35.3%).

Conclusions

The COVID-19 national health alert was associated with significant shifts in the secular trend of cases associated with Enterobacterales outbreaks in Chilean public hospitals, including abrupt increases at the beginning and end of the national health alert period, and gradual decreases during and after this period. A sharp increase in carbapenemase production was observed across outbreaks after the onset of the COVID-19 pandemic.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.