Gandra Sumanth, Alvarez-Uria Gerardo, Stwalley Dustin, Nickel Katelin B, Reske Kimberly A, Kwon Jennie H, Dubberke Erik R, Olsen Margaret A, Burnham Jason P
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA.
Department of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, Anantapur 515661, India.
Antibiotics (Basel). 2023 Mar 8;12(3):537. doi: 10.3390/antibiotics12030537.
Studies comparing the impact of the COVID-19 pandemic on diagnostic microbiology culture yields and antimicrobial resistance proportions in low-to-middle-income and high-income countries are lacking. A retrospective study using blood, respiratory, and urine microbiology data from a community hospital in India and two community hospitals (Hospitals A and B) in St. Louis, MO, USA was performed. We compared the proportion of cultures positive for selected multi-drug-resistant organisms (MDROs) listed on the WHO's priority pathogen list both before the COVID-19 pandemic (January 2017-December 2019) and early in the COVID-19 pandemic (April 2020-October 2020). The proportion of blood cultures contaminated with coagulase-negative (CONS) was significantly higher during the pandemic in all three hospitals. In the Indian hospital, the proportion of carbapenem-resistant (CR) in respiratory cultures was significantly higher during the pandemic period, as was the proportion of CR in urine cultures. In the US hospitals, the proportion of methicillin-resistant in blood cultures was significantly higher during the pandemic period in Hospital A, while no significant increase in the proportion of Gram-negative MDROs was observed. Continuity of antimicrobial stewardship activities and better infection prevention measures are critical to optimize outcomes and minimize the burden of antimicrobial resistance among COVID-19 patients.
缺乏比较新冠疫情对中低收入国家和高收入国家诊断性微生物培养结果及抗菌药物耐药比例影响的研究。我们开展了一项回顾性研究，使用了印度一家社区医院以及美国密苏里州圣路易斯市两家社区医院（A医院和B医院）的血液、呼吸道和尿液微生物学数据。我们比较了世界卫生组织重点病原体清单上列出的特定多重耐药菌（MDRO）在新冠疫情之前（2017年1月至2019年12月）和新冠疫情早期（2020年4月至2020年10月）培养阳性的比例。在所有三家医院中，疫情期间凝固酶阴性葡萄球菌（CONS）污染的血培养比例显著更高。在印度医院，疫情期间呼吸道培养物中耐碳青霉烯类（CR）比例显著更高，尿液培养物中CR比例也是如此。在美国医院，A医院疫情期间血培养中耐甲氧西林比例显著更高，而革兰氏阴性MDRO比例未观察到显著增加。抗菌药物管理活动的连续性和更好的感染预防措施对于优化结果以及将新冠患者的抗菌药物耐药负担降至最低至关重要。
