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新型冠状病毒肺炎大流行如何改变泌尿外科病房的术后感染:来自两个泌尿外科科室的回顾性队列研究

How the COVID-19 pandemic changed postoperative infections in urology wards: A retrospective cohort study from two urology departments.

作者信息

Teixeira Bernardo L, Cabral João, Marques-Pinto André, Vila Fernando, Lindoro Joaquim, Fraga Avelino

机构信息

Department of Urology, Centro Hospitalar Universitário do Porto, Porto, Portugal.

Department of Urology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

出版信息

Can Urol Assoc J. 2022 May;16(5):E267-E273. doi: 10.5489/cuaj.7521.

Abstract

INTRODUCTION

We aimed to compare the rate of postoperative infection and drug-resistant organism (DRO) before and during the COVID-19 pandemic in urology departments.

METHODS

A retrospective cohort study was carried out. Data from all elective surgical procedures carried out in two urology departments between April and June 2018 and the homologous period in 2020 were collected. Main outcomes were the number of postoperative infections during the pandemic and the number of DROs. Sample size was calculated based on a 50% relative reduction of infections during the pandemic. Variables were compared by Chi-squared test, and multivariable logistic regression was used to estimate predictors.

RESULTS

A total of 698 patients undergoing elective surgery were included. The postoperative infection rate during the pre-pandemic period was of 14.1% compared to 12.1% during the pandemic (p=0.494). DROs were lower during the pandemic (92.3% vs. 52.4%, p=0.002). The pandemic period was the main predictor for reduced multidrug-resistant isolates, with an odds ratio of 0.10 (p=0.010, 95% confidence interval 0.016-0.57).

CONCLUSIONS

Postoperative infection rates were not significantly reduced during the COVID-19 pandemic, despite the adoption of enhanced infection preventive measures. There was, however, a decrease in the rate of DROs during this period, suggesting a secondary benefit to enhanced infection prevention practices adopted during the COVID-19 era.

摘要

引言

我们旨在比较泌尿外科在2019冠状病毒病大流行之前和期间的术后感染率及耐药菌(DRO)情况。

方法

开展了一项回顾性队列研究。收集了2018年4月至6月以及2020年同期两个泌尿外科所有择期手术的数据。主要结局指标为大流行期间的术后感染数量及耐药菌数量。样本量根据大流行期间感染率相对降低50%来计算。变量通过卡方检验进行比较,并使用多变量逻辑回归来估计预测因素。

结果

共纳入698例接受择期手术的患者。大流行前时期的术后感染率为14.1%,而大流行期间为12.1%(p = 0.494)。大流行期间耐药菌数量较低(92.3%对52.4%,p = 0.002)。大流行时期是多重耐药菌株减少的主要预测因素,比值比为0.10(p = 0.010,95%置信区间0.016 - 0.57)。

结论

尽管采取了强化感染预防措施,但在2019冠状病毒病大流行期间术后感染率并未显著降低。然而,在此期间耐药菌率有所下降,这表明在2019冠状病毒病时代采取的强化感染预防措施有额外益处。

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