Protective effect of SARS‐CoV‐2 preventive measures against ESKAPE and Escherichia coli infections

• Published in: European journal of clinical investigation Vol. 51; no. 12; pp. e13687 - n/a
• Main Authors: Gaspari, Rita, Spinazzola, Giorgia, Teofili, Luciana, Avolio, Alfonso W., Fiori, Barbara, Maresca, Gian M, Spanu, Teresa, Nicolotti, Nicola, De Pascale, Gennaro, Antonelli, Massimo
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.12.2021; John Wiley and Sons Inc
• Subjects: Acinetobacter baumannii; Acinetobacter Infections - epidemiology; Acinetobacter Infections - microbiology; Acinetobacter Infections - transmission; Aged; Bacteria; Coronaviruses; COVID-19; COVID-19 - prevention & control; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - transmission; Demography; Drug Resistance, Multiple, Bacterial; E coli; Enterobacter; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Enterobacteriaceae Infections - transmission; Enterococcus faecium; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Escherichia coli Infections - transmission; ESKAPEEc; Female; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - transmission; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - transmission; Hand Disinfection; hand hygiene; health care‐associated infections; Humans; Hygiene; Infection Control; Infections; Intensive Care Units; Interrupted Time Series Analysis; Klebsiella; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella Infections - transmission; Klebsiella pneumoniae; Male; Mechanical ventilation; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Multidrug resistance; Organizational Policy; Pandemics; Patients; Personal Protective Equipment; Pseudomonas aeruginosa; Pseudomonas Infections - epidemiology; Pseudomonas Infections - microbiology; Pseudomonas Infections - transmission; Public health; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - transmission; Staphylococcus aureus; Time series; Viral diseases; Visitors to Patients; multidrug resistance; hand hygiene; SARS-CoV-2; personal protective equipment; ESKAPEEc; health care-associated infections
• ISSN: 0014-2972; 1365-2362; 1365-2362
• DOI: 10.1111/eci.13687

Background/Objectives We investigated whether behavioral precautions adopted during Coronavirus disease (COVID‐19) pandemic also influenced the spreading and multidrug resistance (MDR) of ESKAPEEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii [AB], Pseudomonas aeruginosa, Enterobacter spp and Escherichia Coli, [EC]) among Intensive Care Unit (ICU) patients. Subjects/Methods We performed a single‐center retrospective study in adult patients admitted to our COVID‐19‐free surgical ICU. Only patients staying in ICU for more than 48 hours were included. The ESKAPEEc infections recorded during the COVID‐19 period (June 1, 2020 ‐ February 28, 2021) and in the corresponding pre‐pandemic period (June 1, 2019 ‐ February 28, 2020) were compared. An interrupted time series analysis was performed to rule out possible confounders. Results Overall, 173 patients in the COVID‐19 period and 132 in the pre‐COVID‐19 period were investigated. The ESKAPEEc infections were documented in 23 (13.3%) and 35 (26.5%) patients in the pandemic and the pre‐pandemic periods, respectively (p = 0.005). Demographics, diagnosis, comorbidities, type of surgery, Simplified Acute Physiology Score II, length of mechanical ventilation, hospital and ICU length of stay, ICU death rate, and 28‐day hospital mortality were similar in the two groups. In comparison with the pre‐pandemic period, no AB was recorded during COVID‐19 period, (p = 0.017), while extended‐spectrum beta‐lactamase‐producing EC infections significantly decreased (p = 0.017). Overall, the ESKAPEEc isolates during pandemic less frequently exhibited multidrug‐resistant (p = 0.014). Conclusions These findings suggest that a robust adherence to hygiene measures together with human contact restrictions in a COVID‐19 free ICU might also restrain the transmission of ESKAPEEc pathogens.