Trends in fecal carriage of carbapenemase-producing Enterobacterales in children before and after the implementation of international travel restrictions in response to COVID-19

Fecal Carriage and Molecular Characterization of Carbapenemase-Producing Enterobacterales in the Pediatric Population in Qatar

“…In this setting, the remarkable decrease in the mean incidence of CPE carriage registered after the implementation of COVID19-related travel restrictions in mid-March 2020 suggests that asymptomatic sporadic importation from certain regions of the world in which bla OXA-48-type and bla NDM-type genes are endemic is playing a predominant role in shaping the molecular epidemiology of CPE in our pediatric population. It should be kept in mind that our infection control practices did not vary and screening rates remained relatively stable throughout the study period (13). However, since all E. coli ST38 strains carrying bla OXA-244 and bla CTX-M-27 genes were detected in patients without foreign travel history, the role played by clonal expansion locally was not negligible, suggesting that health care facilities and long-term care institutions in Qatar might be a hidden reservoir for this clone.…”

“…Carriage incidences were calculated with the quarterly number of newly identified carriage episodes and expressed by 10,000 hospital admissions. The state of Qatar implemented international travel restrictions on 15 March 2020 to prevent the spread of COVID-19, which resulted in a 95% reduction in the number of international arrivals in Qatar during the rest of 2020, compared with the same period in 2019 (13). In this context, the RR and its 95% CI were reported to compare the risk of CPE carriage between two periods, i.e., before (second quarter of 2018 to first quarter of 2020) and after (second quarter of 2020 to fourth quarter of 2020) the implementation of COVID-19-related travel restrictions.…”

Antimicrobial Resistance in Qatar: Prevalence and Trends before and Amidst the COVID-19 Pandemic

“…A previously matched study from the same institutions highlighted prolonged hospital stay and mechanical ventilation, as well as previous exposure to antimicrobials, as a major risk factor for the acquisition of MRDOs in the critically ill [ 37 ]. Interestingly, a study on CR-EBC colonization in the pediatric population during the pandemic in Qatar found a positive correlation between colonization rates and the number of international travelers [ 13 ]. The absence of a correlation here suggests that the transmission of colonization and infections occurs under different mechanisms.…”

“…The remaining high-priority pathogens were responsible for less than 10% of infections each. Additionally, data on the number of international visitors to Qatar and COVID-19 hospitalizations were collected as described previously [ 13 ].…”

“…Additionally, a recent study conducted in Qatar shed light on imported resistance carriers and whether they may be associated with variations in antimicrobial resistance during the pandemic. Interestingly, the carriage rate for carbapenem-resistant Enterobacteriaceae (CR-EBC) has decreased since the imposition of travel restrictions following the COVID-19 outbreak [ 13 ].…”