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Relationship between COVID-19 and ICU-acquired colonization and infection related to multidrug-resistant bacteria: a prospective multicenter before-after study
- Source :
- Intensive Care Medicine. July, 2023, Vol. 49 Issue 7, p796, 12 p.
- Publication Year :
- 2023
-
Abstract
- Purpose Patients presenting the most severe form of coronavirus disease 2019 (COVID-19) pneumonia, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have a prolonged intensive care unit (ICU) stay and are exposed to broad-spectrum antibiotics, but the impact of COVID-19 on antimicrobial resistance is unknown. Methods Observational prospective before-after study in 7 ICUs in France. All consecutive patients with an ICU stay > 48 h and a confirmed SARS-CoV-2 infection were included prospectively and followed for 28 days. Patients underwent systematic screening for colonization with multidrug-resistant (MDR) bacteria upon admission and every week subsequently. COVID-19 patients were compared to a recent prospective cohort of control patients from the same ICUs. The primary objective was to investigate the association of COVID-19 with the cumulative incidence of a composite outcome including ICU-acquired colonization and/or infection related to MDR bacteria (ICU-MDR-col and ICU-MDR-inf, respectively). Results From February 27th, 2020 to June 2nd, 2021, 367 COVID-19 patients were included, and compared to 680 controls. After adjustment for prespecified baseline confounders, the cumulative incidence of ICU-MDR-col and/or ICU-MDR-inf was not significantly different between groups (adjusted sub-hazard ratio [sHR] 1.39, 95% confidence interval [CI] 0.91-2.09). When considering both outcomes separately, COVID-19 patients had a higher incidence of ICU-MDR-inf than controls (adjusted sHR 2.50, 95% CI 1.90-3.28), but the incidence of ICU-MDR-col was not significantly different between groups (adjusted sHR 1.27, 95% CI 0.85-1.88). Conclusion COVID-19 patients had an increased incidence of ICU-MDR-inf compared to controls, but the difference was not significant when considering a composite outcome including ICU-MDR-col and/or ICU-MDR-inf.<br />Author(s): Louis Kreitmann [sup.1] [sup.2], Sonia Jermoumi [sup.1], Margot Vasseur [sup.1], Myriam Chabani [sup.2], Emilie Nourry [sup.2], Jean-Christophe Richard [sup.3], Florent Wallet [sup.4] [sup.5], Pierre Garçon [sup.6], Safaâ Kachmar [sup.6], [...]
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 49
- Issue :
- 7
- Database :
- Gale General OneFile
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.757724637
- Full Text :
- https://doi.org/10.1007/s00134-023-07109-5