Groupe hospitalo-universitaire APHP Nord-Université de Paris, Site Lariboisière et Fernand Widal, Infection Prevention and Control Team and CIMI-Paris, Inserm U1135, Sorbonne Université, Paris, France.
Groupe hospitalo-universitaire APHP Sorbonne Université, Site Pitié-Salpêtrière, Laboratoire de Bactériologie-Hygiène, Paris, France and Direction des Systèmes d'Information de l'Assistance Publique - Hôpitaux de Paris, Paris, France.
Int J Infect Dis. 2022 Jan;114:90-96. doi: 10.1016/j.ijid.2021.10.034. Epub 2021 Oct 22.
This study measured the impact of the first wave of COVID-19 pandemic (COVID-19) (March-April 2020) on the incidence of bloodstream infections (BSIs) at Assistance Publique - Hôpitaux de Paris (APHP), the largest multisite public healthcare institution in France.
The number of patient admission blood cultures (BCs) collected, number of positive BCs, and antibiotic resistance and consumption were analysed retrospectively for the first quarter of 2020, and also for the first quarter of 2019 for comparison, in 25 APHP hospitals (ca. 14 000 beds).
Up to a fourth of patients admitted in March-April 2020 in these hospitals had COVID-19. The BSI rate per 100 admissions increased overall by 24% in March 2020 and 115% in April 2020, and separately for the major pathogens (Escherichia coli, Klebsiella pneumoniae, enterococci, Staphylococcus aureus, Pseudomonas aeruginosa, yeasts). A sharp increase in the rate of BSIs caused by microorganisms resistant to third-generation cephalosporins (3GC) was also observed in March-April 2020, particularly in K. pneumoniae, enterobacterial species naturally producing inducible AmpC (Enterobacter cloacae...), and P. aeruginosa. A concomitant increase in 3GC consumption occurred.
The COVID-19 pandemic had a strong impact on hospital management and also unfavourable effects on severe infections, antimicrobial resistance, and laboratory work diagnostics.
本研究旨在评估 2020 年 3 月至 4 月（第一波 COVID-19 大流行期间）COVID-19 对法国最大的多院区公立医疗保健机构巴黎公立医院集团（APHP）血流感染（BSI）发病率的影响。
回顾性分析了 2020 年第一季度（3 月至 4 月）25 家 APHP 医院（约 14000 张床位）的患者入院血培养（BC）采集数量、阳性 BC 数量以及抗生素耐药性和消耗量，并与 2019 年同期进行了比较。
这些医院 2020 年 3 月至 4 月收治的患者中，多达四分之一患有 COVID-19。2020 年 3 月和 4 月，每 100 例入院患者的 BSI 发生率总体分别增加了 24%和 115%，主要病原体（大肠埃希菌、肺炎克雷伯菌、肠球菌、金黄色葡萄球菌、铜绿假单胞菌、酵母菌）也是如此。2020 年 3 月至 4 月，还观察到对第三代头孢菌素（3GC）耐药的微生物引起的 BSI 率急剧上升，尤其是在肺炎克雷伯菌、天然产生诱导型 AmpC 的肠杆菌科细菌（阴沟肠杆菌……）和铜绿假单胞菌中。3GC 消耗量也同时增加。
COVID-19 大流行对医院管理产生了重大影响，也对严重感染、抗生素耐药性和实验室工作诊断产生了不利影响。
