Outbreak of endemic carbapenem-resistant <i>Acinetobacter baumannii</i> in a coronavirus disease 2019 (COVID-19)–specific intensive care unit

Shinohara, Danielle Rosani; Saalfeld, Silvia Maria dos Santos; Martinez, Hilton Vizzi; Altafini, Daniela Dambroso; Costa, Bruno Buranello; Fedrigo, Nayara Helisandra; Tognim, Maria Cristina Bronharo

doi:10.1017/ice.2021.98

Cited by 46 publications

(47 citation statements)

References 9 publications

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“…However, the pandemic has also mitigated measures to prevent the spread of MDROs, such as screening, surveillance and antimicrobial stewardship 12 . A number of MDRO outbreaks and infections are now linked to breakdowns in infection prevention practices due to strains imposed by the pandemic 22,23 . Maintaining and monitoring a robust infection prevention practices is very important because the spread of MDRO might pose a long-term serious threat to public health.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study

Son

Kim

Lee

et al. 2021

American Journal of Infection Control

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study

Son

Kim

Lee

et al. 2021

American Journal of Infection Control

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“…Compared to the pre-COVID-19 period, some authors observed a decreased antibiotic susceptibility in local pathogens during the first wave [ 100 ]. Others reported an increased risk of carbapenem-resistant infections in patients hospitalized with COVID-19 [ 18 , 99 ]. In both ICU and non-ICU settings, rigorous adherence to infection control practices is vital to discontinue the transmission of CRAb in hospitals [ 99 , 101 , 102 , 103 ].…”

Section: Sars-cov-2 and A Baumanniimentioning

confidence: 99%

“…All clinical (five cases) and environmental specimens (n = 24) belonged to international clonal lineage 2 ( bla OXA-66 allele) and harbored the bla OXA-24-like carbapenemase [ 109 ]. Shinohara et al also report a monoclonal outbreak of an endemic strain of CRAb (14 cases) in a new COVID-19 ICU of a tertiary teaching hospital in southern Brazil [ 18 ]. Interestingly, CRAb outbreaks in COVID-19 patients seem to be effectively treated with a pre-optimized two-phage cocktail [ 110 ].…”

Section: Sars-cov-2 and A Baumanniimentioning

confidence: 99%

“…For example, COVID-19 patients admitted to ICUs with severe pulmonary symptoms can require the use of mechanical ventilation as part of supportive care. This use of mechanical ventilation can lead to ventilator-associated pneumonia (VAP), especially with multidrug-resistant bacteria such as A. baumannii [ 18 ]. A. baumannii infection cases have been reported in COVID-19 patients [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Acinetobacter baumannii Infections in Times of COVID-19 Pandemic

2021

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The COVID-19 pandemic has generated an overuse of antimicrobials in critically ill patients. Acinetobacter baumannii frequently causes nosocomial infections, particularly in intensive care units (ICUs), where the incidence has increased over time. Since the WHO declared the COVID-19 pandemic on 12 March 2020, the disease has spread rapidly, and many of the patients infected with SARS-CoV-2 needed to be admitted to the ICU. Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbidity and mortality. However, we cannot neglect the increased incidence of antimicrobial resistance, which may be attributed to the excess use of antimicrobial agents during the COVID-19 pandemic. Patients with COVID-19 could be vulnerable to other infections owing to multiple comorbidities with severe COVID-19, prolonged hospitalization, and SARS-CoV-2-associated immune dysfunction. These patients have acquired secondary bacterial infections or superinfections, mainly bacteremia and urinary tract infections. This review will summarize the prevalence of A. baumannii coinfection and secondary infection in patients with COVID-19.

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“…( 26 ) Superinfections by CR-Ab of hospital ICU patients with COVID-19 have been reported in Spain, Mexico and Brazil. ( 11 , 27 , 28 ) Recent work at three hospitals in Bologna, Italy found that the overall incidence of CR-Ab infections increased from 5.1 per 10,000 ICU-patient-days in January-April 2019 to 26.4 per 10,000 ICU-patient-days in January-April 2020. ( 29 ) This suggests a worsening of CR-Ab incidence in ICU patients at these hospitals coincided with the advent of COVID-19.…”

Section: Covid-19 and Antibiotic-resistant Healthcare-associated Infectionsmentioning

confidence: 99%

The interface between COVID-19 and bacterial healthcare-associated infections

O'Toole

2021

Clinical Microbiology and Infection

108

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Background A wide range of bacterial infections occur in COVID-19 patients, particularly, in those with severe coronaviral disease. Some of these are community acquired co-infections. Objective To review recent data which indicate the occurrence of hospital-onset bacterial infections, including with antibiotic-resistant isolates, in COVID-19 patients. Sources Using PubMed, the literature was searched using terms including: “COVID-19”; “SARS-CoV-2”; “bacterial infection”; “healthcare-associated infection”; “antibiotic resistance”; “antimicrobial resistance”; “multi-drug resistance”; “ Streptococcus ”; “ Staphylococcus ”; “ Pseudomonas ”; “ Escherichia ”; “ Klebsiella ”; “ Enterococcus ”; “ Acinetobacter ”; “ Haemophilus ”; “MRSA”; “VRE”; “ESBL”; “NDM-CRE”; “CR-Ab”; “VRSA”; “MDR”. Content There is a growing number of reports of bacterial infections acquired by patients with severe COVID-19 after hospital admission. Antibiotic-resistant pathogens found to cause healthcare-associated infections (HAIs) in COVID-19 patients include Methicillin-Resistant Staphylococcus aureus (MRSA), New Delhi Metallo-β-lactamase-producing Carbapenem-Resistant Enterobacterales (NDM-CRE), Carbapenem-Resistant Acinetobacter baumannii (CR-Ab), Extended-Spectrum β-Lactamase (ESBL) Klebsiella pneumoniae , and Vancomycin-Resistant Enterococci (VRE). COVID-19 has impacted bacterial HAIs in a number of ways with an increase in the incidence of NDM-CRE and CR-Ab reported at some hospital sites compared to before the pandemic. Recommended guidelines for antimicrobial stewardship in COVID-19 patient treatment are discussed regarding minimisation of empiric broad-spectrum antibiotic use. Other studies have reported a decrease in MRSA and VRE cases that has been attributed to enhanced infection prevention and control (IPC) practices introduced to minimise intra-hospital spread of COVID-19. Implications Poorer outcomes have been observed in hospitalised COVID-19 patients with an antibiotic-resistant infection. While heightened IPC measures have been accompanied by a reduction in some HAIs at specific sites, in other situations, COVID-19 has been associated with an increase in bacterial HAI incidence. Further research is needed to define the cost-benefit relationship of maintaining COVID-19-related IPC protocols beyond the pandemic to reduce the burden of HAIs. In addition, the longer-term impact of high usage of certain broad-spectrum antibiotics during the COVID-19 pandemic requires evaluation.

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Outbreak of endemic carbapenem-resistant Acinetobacter baumannii in a coronavirus disease 2019 (COVID-19)–specific intensive care unit

Cited by 46 publications

References 9 publications

Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study

Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study

Acinetobacter baumannii Infections in Times of COVID-19 Pandemic

The interface between COVID-19 and bacterial healthcare-associated infections

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