"Prof. Dr. Matei Bals"National Institute for Infectious Diseases, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Rom J Intern Med. 2021 Nov 20;59(4):409-415. doi: 10.2478/rjim-2021-0020. Print 2021 Dec 1.
Information on healthcare-associated infection (HA-CDI) in COVID-19 patients is limited. We aimed to assess the characteristics of HA-CDI acquired during and before the COVID-19 pandemic. We conducted a retrospective study in a tertiary care hospital, in which since March 2020 exclusively COVID-19 patients are hospitalized. We compared HA-CDI adult patients hospitalized in March 2020-February 2021 with those hospitalized during the same period in 2017-2018. We found 51 cases during 2020-2021 (COVID-19 group), incidence 5.6/1000 adult discharge and 99 cases during 2017-2018 (pre-COVID-19 group), incidence 6.1/1000 adult discharge (p=0.6). The patients in COVID-19 group compared to pre-COVID-19 group were older (median age 66 vs 62 years), with similar rate of comorbidities, but with higher rate of cardiovascular diseases (62.7% vs 42.4%) and less immunosuppression (21.6% vs 55.6%), they had a higher proton pump inhibitors use (94.1% vs 32.3%), and a longer hospitalization (median 19 vs 14 days). Eighty-five (85.9%) patients in pre-COVID-19 group versus 44 (86.3%) patients in COVID-19 group received antimicrobial treatment - mainly cephalosporins (34,1%), quinolones (22,3%) and glycopeptides (21,1%) in pre-COVID-19 group and mainly cephalosporins and macrolides (63,6% each) in COVID-19 group. We found four HA-CDI-related deaths in pre-COVID-19 group and none in the COVID-19 group. The HA-CDI incidence in COVID-19 group did not change versus the same period of time during 2017-2018. The antibiotic use was the most important factor associated with HA-CDI. We identified a high use of broad-spectrum antibiotics despite the lack of empirical antimicrobial recommendations in COVID-19.
有关 COVID-19 患者相关的医院获得性感染（HA-CDI）的信息有限。我们旨在评估 COVID-19 大流行期间和之前获得的 HA-CDI 的特征。我们在一家三级保健医院进行了一项回顾性研究，自 2020 年 3 月以来，该医院仅收治 COVID-19 患者。我们将 2020 年 3 月至 2021 年期间住院的 HA-CDI 成年患者与 2017 年至 2018 年同期住院的患者进行了比较。我们发现 2020-2021 年期间有 51 例（COVID-19 组），发病率为每 1000 名成年出院患者 5.6 例，而 2017-2018 年期间有 99 例（COVID-19 组），发病率为每 1000 名成年出院患者 6.1 例（p=0.6）。与 COVID-19 组相比，COVID-19 组患者年龄更大（中位年龄 66 岁 vs 62 岁），合并症发生率相似，但心血管疾病发生率更高（62.7% vs 42.4%），免疫抑制程度较低（21.6% vs 55.6%），质子泵抑制剂使用率较高（94.1% vs 32.3%），住院时间较长（中位 19 天 vs 14 天）。COVID-19 组中有 85 例（85.9%）患者接受了抗菌治疗，而 COVID-19 组中有 44 例（86.3%）患者接受了抗菌治疗，主要使用头孢菌素（34 例，32.3%）、喹诺酮类（22 例，22.3%）和糖肽类（21 例，21.1%），而 COVID-19 组主要使用头孢菌素和大环内酯类（各 63.6%）。我们发现 COVID-19 组有 4 例与 HA-CDI 相关的死亡，而 COVID-19 组无死亡。COVID-19 组的 HA-CDI 发病率与 2017-2018 年同期相比没有变化。抗生素的使用是与 HA-CDI 最相关的重要因素。尽管 COVID-19 缺乏经验性抗菌治疗建议，但我们发现广泛使用了广谱抗生素。
