Article ; Online: Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic.
The Journal of hospital infection
2023 Volume 137, Page(s) 44–53
Abstract: Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control ... ...
| Abstract | Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Methods: Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Results: Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Conclusions: Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning. |
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| MeSH term(s) | Humans ; Pandemics ; COVID-19 Testing ; COVID-19/epidemiology ; beta-Lactamases ; Hospitals ; Gammaproteobacteria ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Microbial Sensitivity Tests |
| Chemical Substances | beta-lactamase NDM-1 (EC 3.5.2.6) ; beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents |
| Language | English |
| Publishing date | 2023-05-07 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 779366-2 |
| ISSN | 1532-2939 ; 0195-6701 |
| ISSN (online) | 1532-2939 |
| ISSN | 0195-6701 |
| DOI | 10.1016/j.jhin.2023.04.016 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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