NDM-producing Enterobacterales prevalence associated to COVID-19 in a tertiary hospital
Braz. j. infect. dis
;
27(1): 102735, 2023. tab, graf
Artigo
em Inglês
|
LILACS-Express
| LILACS
| ID: biblio-1420732
ABSTRACT
Abstract Colonizations/Infections caused by carbapenem-resistant Enterobacterales are of great clinical and epidemiological importance due to their rapid dissemination and high mortality rates. In this scenario, the use of antibiotics intensified by the COVID-19 pandemic has brought about a great warning on the real impact that this pandemic could have on antimicrobial management programs and long-term antimicrobial resistance rates. The objective of this study was to evaluate the increase of New Delhi Metallo β-Lactamase (NDM)-producing Enterobacterales cases in COVID-19 units of a complex Brazilian tertiary hospital. This retrospective observational study included all patients admitted to the hospital identified as colonized or infected by NDM-producing Gram negative bacilli (GNB), from January 2017 to April 2021. Forty-two NDM-producing Enterobacterales were identified in 39 patients. The rate of NDM cases per total surveillance cultures increased progressively between 2017 and 2021 (chi-2 for trend, p < 0.0001) and was associated with a higher occurrence specifically in COVID units (Fisher exact, p < 0.0001). The molecular investigation of the NDM-producing Klebsiella pneumoniae strains revealed the emergence of diverse clones during the COVID-19 period, also with possible evidence of horizontal transmission among patients within COVID units. NDM-producing Enterobacterales with multiple and different clonalities in the COVID-19 units also raised questions about the importance of other factors besides horizontal clonal transfer, including the increase of antimicrobial consumption by these patients.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Tipo de estudo:
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Assunto da revista:
Doenças Transmissíveis
Ano de publicação:
2023
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Associação Fundo de Incentivo a Pesquisa (AFIP - Medicina Diagnóstica)/BR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Universidade Federal de São Paulo/BR
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