A Change in Nosocomial Infections among Surgical ICU Patients in the COVID-19 Era and MALDI-TOF Mass Spectrometry-A Cross-Sectional Study

• Published in: Microorganisms (Basel) Vol. 12; no. 8; p. 1510
• Main Authors: Jedud, Leon, Cicvarić, Ana, Bogdan, Maja, Koulenti, Despoina, Rello, Jordi, Debeljak, Željko, Kralik, Kristina, Mandic, Dario, Kvolik, Slavica
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.07.2024; MDPI
• Subjects: Antibiotics; Bacteria; Cerebrospinal fluid; Chi-square test; Control methods; COVID-19; COVID-19 pandemic; Croatia; Cross-sectional studies; Drug resistance in microorganisms; Gene frequency; Gram-negative bacteria; Gram-positive bacteria; Health aspects; Hospital patients; Hospitals; Identification; Infection; Intensive care; MALDI-MS; Mass spectrometry; Mass spectroscopy; microbiology; Microorganisms; Mortality; Nosocomial infection; Nosocomial infections; Pandemics; Pathogens; Patients; Population studies; Registration; Respiratory system; Scientific imaging; Severe acute respiratory syndrome coronavirus 2; Software; Statistical analysis; Streptococcus infections; surgical intensive care; Surveillance; Yeast; Croatia; COVID-19 pandemic; bacteria; enterobacteria; microbiology; MALDI-MS; surgical intensive care; nosocomial infections; critical care outcome; big data
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms12081510

During the COVID-19 pandemic, changes occurred within the surgical patient population. An increase in the frequency of resistant Gram-negative bacteria has since been recorded worldwide. After the start of the COVID-19 pandemic, microbiological diagnostics in our institution was performed using MALDI-TOF mass spectrometry. With this study, we wanted to confirm whether it contributed to a greater number of pathogenic bacteria detected in surgical ICU patients. A total of 15,033 samples taken from 1781 surgical patients were compared during the period from 2016 to February 2020 and during the COVID-19 pandemic from March 2020 to February 2023. On patients' admission, pathogenic bacteria were mostly isolated from the respiratory system (43.1% and 44.9%), followed by urine cultures (18.4 vs. 15.4%) before and during the pandemic. After the onset of the COVID-19 pandemic, there was a significant increase in the frequency of isolation of spp. (5.4 before vs. 9%, = 0.014) and other enterobacteria (6.9 vs. 10.8%, = 0.017) on patients' admission to the ICU, respectively. Despite this change, mortality in the ICU during the post-COVID-19 period was reduced from 23 to 9.6% ( < 0.001). The frequency of bacterial isolation did not change with the application of MALDI-TOF technology. By identifying the microorganism while simultaneously recognizing some resistance genes, we were able to start targeted therapy earlier. With the application of other infection control methods, MALDI-TOF may have contributed to the reduction in mortality in surgical ICU patients during the COVID-19 pandemic.