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Article

Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

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Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
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Clinical Microbiology Laboratory, Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
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Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
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Infection Control and Hospital Epidemiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
*
Author to whom correspondence should be addressed.
Academic Editor: Italo Francesco Angelillo
Received: 20 January 2021 / Revised: 2 February 2021 / Accepted: 3 February 2021 / Published: 11 February 2021
(This article belongs to the Special Issue Antibiotics Use and Antimicrobial Resistance in Hospital)
Objective: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. Methods: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. Results: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05). Conclusion: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively. View Full-Text
Keywords: antimicrobial use; COVID-19; hospital-acquired infections antimicrobial use; COVID-19; hospital-acquired infections
MDPI and ACS Style

Martinez-Guerra, B.A.; Gonzalez-Lara, M.F.; de-Leon-Cividanes, N.A.; Tamez-Torres, K.M.; Roman-Montes, C.M.; Rajme-Lopez, S.; Villalobos-Zapata, G.I.; Lopez-Garcia, N.I.; Martínez-Gamboa, A.; Sifuentes-Osornio, J.; Ortiz-Brizuela, E.; Ochoa-Hein, E.; Galindo-Fraga, A.; Bobadilla-del-Valle, M.; Ponce-de-León, A. Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic. Antibiotics 2021, 10, 182. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020182

AMA Style

Martinez-Guerra BA, Gonzalez-Lara MF, de-Leon-Cividanes NA, Tamez-Torres KM, Roman-Montes CM, Rajme-Lopez S, Villalobos-Zapata GI, Lopez-Garcia NI, Martínez-Gamboa A, Sifuentes-Osornio J, Ortiz-Brizuela E, Ochoa-Hein E, Galindo-Fraga A, Bobadilla-del-Valle M, Ponce-de-León A. Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic. Antibiotics. 2021; 10(2):182. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020182

Chicago/Turabian Style

Martinez-Guerra, Bernardo A., Maria F. Gonzalez-Lara, Nereyda A. de-Leon-Cividanes, Karla M. Tamez-Torres, Carla M. Roman-Montes, Sandra Rajme-Lopez, G. I. Villalobos-Zapata, Norma I. Lopez-Garcia, Areli Martínez-Gamboa, Jose Sifuentes-Osornio, Edgar Ortiz-Brizuela, Eric Ochoa-Hein, Arturo Galindo-Fraga, Miriam Bobadilla-del-Valle, and Alfredo Ponce-de-León. 2021. "Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic" Antibiotics 10, no. 2: 182. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020182

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