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Article: Epidemiology of multidrug-resistant organisms before and during COVID-19 in Hong Kong

TitleEpidemiology of multidrug-resistant organisms before and during COVID-19 in Hong Kong
Authors
KeywordsCarbapenem-resistant Acinetobacter species
COVID-19
Epidemiology
ESBL-producing Enterobacterales
Methicillin-resistant Staphylococcus aureus
Multidrug-resistant organisms
Issue Date8-May-2023
PublisherElsevier Ltd.
Citation
Infection Prevention in Practice, 2023, v. 5, n. 2 How to Cite?
Abstract

Background: The coronavirus disease 2019 (COVID-19) has influenced antimicrobial consumption and incidence of multidrug-resistant organisms (MDROs). We aimed to study the epidemiology of MDROs before and during the COVID-19 pandemic in Hong Kong.

Methods: With the maintenance of infection control measures, we described the trend of MDRO infections, including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum-beta-lactamase-(ESBL)-producing Enterobacterales, in a healthcare region with 3100-bed before (1 January 2016 to 31 December 2019, period 1) and during COVID-19 (1 January 2020 to 30 September 2022, period 2), together with the antimicrobial consumption using piecewise Poisson regression. The epidemiological characteristics of newly diagnosed COVID-19 patients with or without MDRO infections were analyzed.

Results: Between period 1 and 2, we observed a significant increase in the trend of CRA infections (P<0.001), while there was no significant increase in the trend of MRSA (P=0.742) and ESBL-producing Enterobacterales (P=0.061) infections. Meanwhile, a significant increase in the trend of carbapenems (P<0.001), extended-spectrum beta-lactam-beta-lactamase inhibitor combinations (BLBI) (P=0.045), and fluoroquinolones (P=0.009) consumption was observed. The observed opportunity (23,540 ± 3703 vs 26,145 ± 2838, p=0.359) and compliance (81.6% ± 0.5% vs 80.1% ± 0.8%, P=0.209) of hand hygiene per year was maintained. In a multivariable model, older age, male sex, referral from residential care home for the elderly, presence of indwelling device, presence of endotracheal tube, and use of carbapenems, use of BLBI, use of proton pump inhibitors and history of hospitalization in the past 3 months were associated with higher risks of infections by MDROs among COVID-19 patients.

Conclusion: Infection control measures may control the surge of MDROs despite an increasing trend of antimicrobial consumption.


Persistent Identifierhttp://hdl.handle.net/10722/328960
ISSN
2023 Impact Factor: 1.8
2023 SCImago Journal Rankings: 0.547
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, Shuk Ching-
dc.contributor.authorChau, Pui Hing-
dc.contributor.authorSo, Simon Yung Chun-
dc.contributor.authorChiu, Kelvin Hei Yeung-
dc.contributor.authorYuen, Lithia Lai Ha-
dc.contributor.authorAu Yeung, Christine Ho Yan-
dc.contributor.authorLam, Germaine Kit Ming-
dc.contributor.authorChan, Veronica Wing Man-
dc.contributor.authorChen, Jonathan Hon Kwan-
dc.contributor.authorChen, Hong-
dc.contributor.authorLi, Xin-
dc.contributor.authorHo, Pak Leung-
dc.contributor.authorChan, Sophia Siu Chee-
dc.contributor.authorYuen, Kwok Yung-
dc.contributor.authorCheng, Vincent Chi-Chung-
dc.date.accessioned2023-08-05T07:54:14Z-
dc.date.available2023-08-05T07:54:14Z-
dc.date.issued2023-05-08-
dc.identifier.citationInfection Prevention in Practice, 2023, v. 5, n. 2-
dc.identifier.issn2590-0889-
dc.identifier.urihttp://hdl.handle.net/10722/328960-
dc.description.abstract<p>Background: The coronavirus disease 2019 (COVID-19) has influenced antimicrobial consumption and incidence of multidrug-resistant organisms (MDROs). We aimed to study the epidemiology of MDROs before and during the COVID-19 pandemic in Hong Kong.</p><p>Methods: With the maintenance of infection control measures, we described the trend of MDRO infections, including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum-beta-lactamase-(ESBL)-producing Enterobacterales, in a healthcare region with 3100-bed before (1 January 2016 to 31 December 2019, period 1) and during COVID-19 (1 January 2020 to 30 September 2022, period 2), together with the antimicrobial consumption using piecewise Poisson regression. The epidemiological characteristics of newly diagnosed COVID-19 patients with or without MDRO infections were analyzed.</p><p>Results: Between period 1 and 2, we observed a significant increase in the trend of CRA infections (P<0.001), while there was no significant increase in the trend of MRSA (P=0.742) and ESBL-producing Enterobacterales (P=0.061) infections. Meanwhile, a significant increase in the trend of carbapenems (P<0.001), extended-spectrum beta-lactam-beta-lactamase inhibitor combinations (BLBI) (P=0.045), and fluoroquinolones (P=0.009) consumption was observed. The observed opportunity (23,540 ± 3703 vs 26,145 ± 2838, p=0.359) and compliance (81.6% ± 0.5% vs 80.1% ± 0.8%, P=0.209) of hand hygiene per year was maintained. In a multivariable model, older age, male sex, referral from residential care home for the elderly, presence of indwelling device, presence of endotracheal tube, and use of carbapenems, use of BLBI, use of proton pump inhibitors and history of hospitalization in the past 3 months were associated with higher risks of infections by MDROs among COVID-19 patients.</p><p>Conclusion: Infection control measures may control the surge of MDROs despite an increasing trend of antimicrobial consumption.</p>-
dc.languageeng-
dc.publisherElsevier Ltd.-
dc.relation.ispartofInfection Prevention in Practice-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCarbapenem-resistant Acinetobacter species-
dc.subjectCOVID-19-
dc.subjectEpidemiology-
dc.subjectESBL-producing Enterobacterales-
dc.subjectMethicillin-resistant Staphylococcus aureus-
dc.subjectMultidrug-resistant organisms-
dc.titleEpidemiology of multidrug-resistant organisms before and during COVID-19 in Hong Kong-
dc.typeArticle-
dc.identifier.doi10.1016/j.infpip.2023.100286-
dc.identifier.scopuseid_2-s2.0-85160056314-
dc.identifier.volume5-
dc.identifier.issue2-
dc.identifier.isiWOS:001023398500001-
dc.identifier.issnl2590-0889-

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