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两年后新冠疫情对导管相关血流感染发病率及流行病学的影响。

Impact of the COVID-19 pandemic on the incidence and the epidemiology of catheter-related bloodstream infection two years later.

作者信息

Pérez-Granda María Jesús, Burillo Almudena, Serrano-Lobo Julia, Martín-Rabadán Pablo, Muñoz Patricia, Bouza Emilio, Guembe María

机构信息

Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

CIBER de Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.

出版信息

Heliyon. 2024 Jul 7;10(14):e34185. doi: 10.1016/j.heliyon.2024.e34185. eCollection 2024 Jul 30.

Abstract

INTRODUCTION

The COVID-19 pandemic increased catheter-related bloodstream infections (C-RBSI), but its subsequent impact has not been adequately described. Our hospital has already depicted the effects of the COVID-19 pandemic in the first wave. However, we still do not know whether C-RBSI rates and aetiology are similar to those described before the COVID-19 pandemic. We aimed to evaluate the impact of the COVID-19 pandemic on the evolution of C-RBSI in a large tertiary teaching hospital two years later.

MATERIAL AND METHODS

We prospectively collected all confirmed C-RBSI episodes in a clinical microbiology laboratory database by matching blood cultures and catheter tip cultures with the isolation of the same microorganism (s). We compared our C-RBSI incidence rates and aetiology from 2018 to 2023. C-RBSI was defined as bacteremia or fungemia in a patient with clinical manifestations of infection and no other apparent source except the catheter.

RESULTS

During the study period, we collected 556 C-RBSI episodes. C-RBSI incidence rate per 1000 admissions each year was as follows: 2018: 2.2; 2019: 1.7; 2020: 3.29; 2021: 2.92; 2022: 2.69. and 2023: 2.01. Mainly, C-RBSI episodes occurring in critical care units each year were, respectively: 2018: 57 (54.8 %), 2019: 38 (45.2 %), 2020: 89 (63.6 %), 2021: 69 (60.5 %), 2022: 58 (50.9 %) and 2023 (61.4 %). The distribution of microorganisms showed an increase in Gram-negative episodes after the pandemic.

CONCLUSION

Our study shows an increase in the incidence rate of C-RBSI during the COVID-19 pandemic, with a discrete decrease after that. C-RBSI episodes were mainly caused by coagulase-negative Staphylococci but with a rise in Gram-negative bacilli.

摘要

引言

新冠疫情期间导管相关血流感染(C-RBSI)有所增加,但其后续影响尚未得到充分描述。我院已描述了新冠疫情第一波的影响。然而,我们仍不清楚C-RBSI的发生率和病因是否与新冠疫情之前所描述的相似。我们旨在评估两年后新冠疫情对一家大型三级教学医院C-RBSI演变的影响。

材料与方法

我们通过将血培养和导管尖端培养与相同微生物的分离情况进行匹配,前瞻性地收集了临床微生物学实验室数据库中所有确诊的C-RBSI病例。我们比较了2018年至2023年期间我院C-RBSI的发生率和病因。C-RBSI被定义为有感染临床表现且除导管外无其他明显感染源的患者发生的菌血症或真菌血症。

结果

在研究期间,我们收集了556例C-RBSI病例。每年每1000例住院患者的C-RBSI发生率如下:2018年:2.2;2019年:1.7;2020年:3.29;2021年:2.92;2022年:2.69;2023年:2.01。每年主要发生在重症监护病房的C-RBSI病例分别为:2018年:57例(54.8%),2019年:38例(45.2%),2020年:89例(63.6%),2021年:69例(60.5%),2022年:58例(50.9%),2023年:61.4%。微生物分布显示疫情后革兰阴性菌感染病例有所增加。

结论

我们的研究表明,新冠疫情期间C-RBSI的发生率有所上升,但之后有明显下降。C-RBSI病例主要由凝固酶阴性葡萄球菌引起,但革兰阴性杆菌的比例有所上升。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c76d/11298837/6c45458f89f2/gr1.jpg

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