Social distancing and bacteraemia in the time of <scp>COVID</scp>‐19

Feldman, Itamar; Natsheh, Ayman; Nesher, Gideon; Breuer, Gabriel S.

doi:10.1111/imj.15560

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…The observed changes in the microbiology of BSI likely represent true epidemiologic shifts during the pandemic. Decreased community-acquired S. pneumoniae infections have been described in recent studies ( 30 – 32 ); we identified this same trend in addition to a decline in S. aureus . These changes may be due to public health measures leading to a decrease in both the community transmission of these pathogens and of respiratory viruses such as influenza that can result in secondary bacterial pneumonia due to these pathogens ( 33 , 34 ).…”

Section: Discussionsupporting

confidence: 85%

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

Driedger,

Daneman,

Brown

et al. 2023

Microbiol Spectr

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The COVID-19 pandemic has likely influenced the epidemiology of bacterial infections through wide-ranging changes to clinical practices and infection control and prevention interventions. We sought to determine how the detection and incidence of bloodstream infections (BSIs) have been influenced by the pandemic. We performed a retrospective analysis of blood culture data in the province of Ontario, Canada, from 1 January 2017 to 31 December 2020. Outcomes included a weekly incidence of blood culture tests, BSIs, and contaminant results. Results were stratified by hospital, community, and long-term care (LTC) settings. An interrupted time series analysis using segmented regression models was used to determine changes in outcome incidence/prevalence during the pre- and peri-pandemic periods. Of the 14,083,853 individuals included, 129,329 (0.92%) developed a bloodstream infection. The blood culture ordering rate increased during the pandemic in the hospital setting only [Incidence rate ratio (IRR) 1.09, 95% confidence interval (CI) 1.01–1.19]. There was a decline in the incidence of community-acquired (IRR 0.95, 95% CI 0.91–0.99) and LTC-acquired (IRR 0.85, 95% CI 0.76–0.94) BSIs. Hospital-acquired BSIs were unchanged. The proportion of blood culture contaminants increased in the community (7% increase, P < 0.01) and LTC settings (14% increase, P < 0.05). There was decreased incidence of community-acquired Streptococcus pneumoniae (IRR 0.43, 95% CI 0.33–0.57) and Staphylococcus aureus (IRR 0.91, 95% CI 0.84–0.99) bacteremia. Pandemic-related changes in the performance of blood cultures and the epidemiology of BSIs have implications for current and future pandemic antimicrobial use, healthcare resource allocation, and hospital and laboratory policies. IMPORTANCE Bacterial infections are a significant cause of morbidity and mortality worldwide. In the wake of the COVID-19 pandemic, previous studies have demonstrated pandemic-related shifts in the epidemiology of bacterial bloodstream infections (BSIs) in the general population and in specific hospital systems. Our study uses a large, comprehensive data set stratified by setting [community, long-term care (LTC), and hospital] to uniquely demonstrate how the effect of the COVID-19 pandemic on BSIs and testing practices varies by healthcare setting. We showed that, while the number of false-positive blood culture results generally increased during the pandemic, this effect did not apply to hospitalized patients. We also found that many infections were likely under-recognized in patients in the community and in LTC, demonstrating the importance of maintaining healthcare for these groups during crises. Last, we found a decrease in infections caused by certain pathogens in the community, suggesting some secondary benefits of pandemic-related public health measures.

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Section: Discussionsupporting

confidence: 85%

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

Driedger,

Daneman,

Brown

et al. 2023

Microbiol Spectr

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“…significantly reduced in blood samples [18]. A significant reduction in coagulase-negative staphylococci infections was also reported in another study, which reported a reduction in the number of infections caused by this pathogen from 93 cases in the pre-COVID-19 pandemic to 60 cases during the COVID-19 pandemic [17]. Conversely, the number of some pathogens increased significantly during the COVID-19 pandemic, including S. viridans and Enterococcus.…”

Section: Discussionsupporting

confidence: 69%

“…in the tracheal culture and coagulase-negative staphylococci in the blood culture decreased significantly in the postCO-VID-19 pandemic. Previous studies have also reported the decline of these pathogens during the COVID-19 pandemic [17]. In a multicenter ecological analysis, during the period of quarantine and social distancing, Enterobacterales spp.…”

Section: Discussionmentioning

confidence: 92%

The Predominant Microorganism During the COVID-19 Pandemic in the Toxicological Intensive Care Unit

Dahi,

Talaie,

Sabeti

et al. 2023

IJMTFM

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Background: Although many studies have investigated the prevalence of hospital infections during the COVID-19 pandemic, the results are still challenging. Methods: In this routine data-based study, the medical records of 2213 poisoned patients admitted to the Toxicological Intensive Care Unit (TICU) of the Loghman Hakim Hospital from 2018 to 2022 were retrospectively reviewed. After the implementation of exclusion criteria, 220 patients were separated into the control and case groups. The information of the patients was extracted based on a preplanned form and analyzed with SPSS software, version 26. Results: Unlike the prepandemic period, when Staphylococcus aureus was the predominant pathogen, during the pandemic period, the predominant pathogen in tracheal culture was Acinetobacter spp., which increased from 11.3% in the prepandemic period to 14.9% during the COVID-19 pandemic. Moreover, coagulase-negative staphylococci in blood culture and Enterobacter spp. in tracheal culture both significantly decreased during the COVID-19 pandemic (P=0.035 and P=0.05, respectively), while Streptococcus viridans in the tracheal culture and Enterococcus in the urine culture both significantly increased (P=0.013). Conclusion: Although in the prepandemic period, S. aureus was usually the most common pathogen among poisoned patients in TICU, the predominant pathogen changed to Acinetobacter spp. during the COVID-19 pandemic period. Some hospital-acquired infections decreased and others increased in a different way between the two groups.

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“…In a context of reduced social interactions and reorganization of the health-care system, atypical clinical presentations of bacteremia and changed incidence of invasive infections related to human-transmitted pathogens were indirect consequences of containment. This was described by Feldman et al [7] , who found decreased incidence of S. pneumoniae bacteremia associated with social distancing measures, without any adjustment on the overall activity of the recruiting center; these results confirmed on a larger scale the findings of the international multicenter study by Brueggemann et al [8] . A Spanish study conducted by Mormeneo Bayo et al [9] , reported a decreased number of blood cultures taken in a hospital during lockdown (second quarter 2020) compared to the same period in 2018 and 2019 (-18.8% and -22.7% p=0.173 respectively), which remains to be confirmed.…”

Section: Introductionsupporting

confidence: 84%

Lesson from the COVID-19 pandemic lockdown: A major change of hospital-diagnosed bacteremia epidemiology

Cauhapé¹,

Lamy²,

Lotte³

et al. 2023

Infectious Diseases Now

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Social distancing and bacteraemia in the time of COVID‐19

Cited by 6 publications

References 19 publications

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections

The Predominant Microorganism During the COVID-19 Pandemic in the Toxicological Intensive Care Unit

Lesson from the COVID-19 pandemic lockdown: A major change of hospital-diagnosed bacteremia epidemiology

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