COVID-19 大流行对瑞士重症监护病房血培养阳性的流行病学影响：一项全国性监测研究。
The effect of the COVID-19 pandemic on the epidemiology of positive blood cultures in Swiss intensive care units: a nationwide surveillance study.
机构信息
Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland.
出版信息
Crit Care. 2021 Nov 22;25(1):403. doi: 10.1186/s13054-021-03814-z.
BACKGROUND
Evidence about the impact of the pandemic of COVID-19 on the incidence rates of blood cultures contaminations and bloodstream infections in intensive care units (ICUs) remains scant. The objective of this study was to investigate the nationwide epidemiology of positive blood cultures drawn in ICUs during the first two pandemic waves of COVID-19 in Switzerland.
METHODS
We analyzed data on positive blood cultures among ICU patients, prospectively collected through a nationwide surveillance system (ANRESIS), from March 30, 2020, to May 31, 2021, a 14-month timeframe that included a first wave of COVID-19, which affected the French and Italian-speaking regions, an interim period (summer 2020) and a second wave that affected the entire country. We used the number of ICU patient-days provided by the Swiss Federal Office of Public Health as denominator to calculate incidence rates of blood culture contaminations and bloodstream infections (ICU-BSI). Incidence rate ratios comparing the interim period with the second wave were determined by segmented Poisson regression models.
RESULTS
A total of 1099 blood culture contaminations and 1616 ICU-BSIs were identified in 52 ICUs during the study. Overall, more episodes of blood culture contaminations and ICU-BSI were observed during the pandemic waves, compared to the interim period. The proportions of blood culture contaminations and ICU-BSI were positively associated with the ICU occupancy rate, which was higher during the COVID-19 waves. During the more representative second wave (versus interim period), we observed an increased incidence of blood culture contaminations (IRR 1.57, 95% CI 1.16-2.12) and ICU-BSI (IRR 1.20, 95% CI 1.03-1.39).
CONCLUSIONS
An increase in blood culture contaminations and ICU-BSIs was observed during the second COVID-19 pandemic wave, especially in months when the ICU burden of COVID-19 patients was high.
背景
关于 COVID-19 大流行对重症监护病房（ICU）中血培养污染和血流感染发生率影响的证据仍然很少。本研究的目的是调查瑞士 COVID-19 大流行的前两个浪潮期间 ICU 中抽取的阳性血培养的全国流行病学情况。
方法
我们分析了 2020 年 3 月 30 日至 2021 年 5 月 31 日期间，通过全国性监测系统（ANRESIS）前瞻性收集的 ICU 患者阳性血培养数据，该时间段为 14 个月，包括 COVID-19 的第一波，影响了法语和意大利语区，一个中间期（2020 年夏季）和第二波，影响了整个国家。我们使用瑞士联邦公共卫生办公室提供的 ICU 患者住院日数作为分母来计算血培养污染和血流感染（ICU-BSI）的发病率。使用分段泊松回归模型确定中间期与第二波相比的发病率比。
结果
在研究期间，52 个 ICU 中发现了 1099 例血培养污染和 1616 例 ICU-BSI。总体而言，与中间期相比，大流行期间观察到更多的血培养污染和 ICU-BSI 事件。血培养污染和 ICU-BSI 的比例与 ICU 入住率呈正相关，而 COVID-19 期间的 ICU 入住率更高。在更具代表性的第二波（与中间期相比）中，我们观察到血培养污染的发病率增加（IRR 1.57，95%CI 1.16-2.12）和 ICU-BSI（IRR 1.20，95%CI 1.03-1.39）。
结论
在第二波 COVID-19 大流行期间，观察到血培养污染和 ICU-BSI 的增加，尤其是在 COVID-19 患者 ICU 负担高的月份。
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