在法国 COVID-19 大流行期间，大肠杆菌感染中产生超广谱β-内酰胺酶的比例下降。
Decreasing proportion of extended-spectrum beta-lactamase among E. coli infections during the COVID-19 pandemic in France.
机构信息
Centre d'appui à la prévention des infections associées aux soins des Pays de la Loire. CHU - Le Tourville, 5 rue Pr Yves Boquien, Nantes 44093, France.
Département des Maladies Infectieuses, Santé Publique France, Saint Maurice, France.
出版信息
J Infect. 2021 Dec;83(6):664-670. doi: 10.1016/j.jinf.2021.09.016. Epub 2021 Sep 29.
OBJECTIVES
We investigated the impact of the COVID-19 and national pandemic response on the epidemiology of Extended Spectrum Beta-Lactamase producing E. coli (ESBL-E.coli) in France.
METHODS
Individual microbiology records from clinical laboratories were analyzed between 1 January 2019 to 31 December 2020. The ESBL-E.coli rates from clinical samples of patients in primary care and nursing home residents were compared before and after the general lockdown in March 2020, according to demographic and geographical characteristics. Interrupted time series analyses were performed to detect measurable changes in the trend of ESBL-E.coli rates.
RESULTS
Records covering 793,954 E. coli isolates from 1022 clinical laboratories were analyzed. In primary care, 3.1% of E. coli isolates from clinical samples were producing ESBL before March 2020 and 2.9% since May 2020 (p < 0.001). The proportion of ESBL-E.coli decreased significantly among urine cultures, females, age categories 5-19, 40-64, > 65 year-old, and in the North, West, East and South-East regions. In nursing home, the ESBL-E.coli rate was 9.3% (monthly rate min-max: 6.5-10.5%) before March 2020 and 8.3% (7.2-9.1%) since May 2020 (p < 0.001). The reduction rate accelerated from -0.04%/month to -0.22%/month from May 2020 (p < 0.001).
CONCLUSION
Investigation of factors that led to the decreased proportion of ESBL-E.coli during the COVID-19 pandemic is urgently needed.
目的
我们研究了 COVID-19 大流行和国家大流行应对措施对法国产超广谱β-内酰胺酶大肠埃希菌（ESBL-E.coli）流行病学的影响。
方法
分析了 2019 年 1 月 1 日至 2020 年 12 月 31 日期间来自临床实验室的个体微生物学记录。根据人口统计学和地理位置特征，比较了 2020 年 3 月全面封锁前后初级保健和护理院居民临床样本中 ESBL-E.coli 的发生率。采用中断时间序列分析来检测 ESBL-E.coli 发生率趋势中的可衡量变化。
结果
分析了来自 1022 个临床实验室的 793954 株大肠埃希菌的记录。在初级保健中，2020 年 3 月之前，临床样本中 3.1%的大肠埃希菌产生 ESBL，而 2020 年 5 月以来为 2.9%（p<0.001）。尿液培养物、女性、5-19 岁、40-64 岁、>65 岁和北部、西部、东部和东南部地区的 ESBL-E.coli 比例显著下降。在护理院，2020 年 3 月之前，ESBL-E.coli 的发生率为 9.3%（每月发生率最小-最大：6.5-10.5%），而 2020 年 5 月以来为 8.3%（7.2-9.1%）（p<0.001）。自 2020 年 5 月以来，下降速度从每月 -0.04%加快至 -0.22%（p<0.001）。
结论
迫切需要调查导致 COVID-19 大流行期间 ESBL-E.coli 比例下降的因素。
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