An Observational Study to Determine the Prevalence of COVID-19 Among Hospitalized Patients With Multidrug-Resistant Enterobacterales Infections and Clinical Outcomes, 10 US Sites, 2020–2022.

ingentiumby ingentium

In Clinical Literature.

Publication date: Jan 01, 2025

We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022. We defined a CRE case as the first isolation of Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes, K oxytoca, K pneumoniae, or K variicola resistant to any carbapenem. We defined an ESBL-E case as the first isolation of E coli, K pneumoniae, or K oxytoca resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses. Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2. 4%) and 60 (3. 2%), respectively, had a SC2. Among these cases, a SC2 was associated with intensive care unit admission (adjusted odds ratio [aOR], 1. 69 [95% CI, 1. 14-2. 50]; aOR, 1. 48 [95% CI, 1. 03-2. 12]) and 30-day mortality (aOR, 1. 79 [95% CI, 1. 22-2. 64]; aOR, 1. 94 [95% CI, 1. 39-2. 70]). CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19.

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Concepts Keywords
Antibiotic carbapenem-resistant Enterobacterales
Klebsiella COVID-19
Nonresistant SARS-CoV-2
Pneumoniae

Semantics

Type Source Name
disease MESH COVID-19
disease MESH Infections
disease IDO site
disease IDO infection
disease MESH Infectious Diseases
drug DRUGBANK Methylphenidate
disease MESH coinfections
disease MESH critically ill
disease MESH tics
drug DRUGBANK Doripenem
drug DRUGBANK Ertapenem
drug DRUGBANK Imipenem
drug DRUGBANK Meropenem
disease IDO blood
drug DRUGBANK Ceftazidime
drug DRUGBANK Cefotaxime
drug DRUGBANK Etoperidone
disease MESH Comorbidity
disease IDO history
disease IDO facility
disease MESH myocardial infarction
disease MESH congestive heart failure
disease MESH congenital heart disease
disease MESH stroke
disease MESH transient ischemic attack
disease MESH peripheral vascular disease
disease MESH cystic fibrosis
disease MESH dyspnea
disease MESH pressure ulcer
disease MESH ulcer
disease MESH diverticular disease
disease MESH inflammatory bowel disease
pathway KEGG Inflammatory bowel disease
disease MESH peptic ulcer
disease MESH syndrome
disease MESH liver disease
disease MESH Bacteremia
disease MESH Pyelonephritis
disease MESH Septic shock
disease MESH Pneumonia

Original Article

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