P0125 Post-operative infections, a silver lining from the COVID-19 pandemic. A retrospective cohort study from urology departments

ABSTRACT

Introduction & Objectives: In response to the COVID-19 pandemic, hospitals had to reorganize, and sanitation measures were reinforced. Some of these procedures have been shown to lower the rate of hospital acquired infections, and as a result, we hypothesise that the occurrence of postoperative infection during the pandemic would be lower. The objective of this study is to compare the rate of post-operative infections and patterns of antimicrobial resistance before and during the pandemic in Urology departments. Materials & Methods: An observational retrospective cohort study was carried out in two centers in Portugal. Data from all elective surgical procedures between April and June 2018 and the homologous period in 2020 were collected. Outpatient and non-elective surgeries were excluded. Patient data included age, sex, post-operative in-hospital length of stay, American Society of Anaesthesiologist (ASA) score, type of procedure, antibiotic prophylaxis, pre-operative urine cultures, peri-operative use of medical devices, post-operative infections, microbial culture and antimicrobial susceptibility testing. Infection was defined according to the European Centre for Disease Prevention and Control (ECDC) protocol. Multidrug resistant (MDR) organism was defined asa microorganism resistant toone or more classes of antimicrobial agents tested. Main outcomes were the number of post-operative infections during the pandemic and the number of MDR isolates. Results: Baseline characteristis are presented in Table 1. The post-operative infection rate during the pre-pandemic period was of 14.1% compared to 12.1% during the pandemic (p=0.494). Ninety two percent of isolates were MDR in the pre-pandemic period compared to 52 % during the pandemic (p=0.002). The pandemic period was associated with a reduced risk for MDR isolate's on multivariate logistic regression analysis (OR - 0.1;95% CI0.07 - 0.57;p=0.010), but not with reduced number of infections (OR - 0.84;95% CI 0.53-1.34;p=0.47). (Table presented.) Conclusions: MDR isolates were lower during the pandemic in Urology wards, possibly as an indirect result of COVID-19 preventive measures, such as increased hand hygiene, room disinfection and reduced family visits to inpatients. No statistically significant difference was found between the number of post-operative infections in our sample. Further reports, such as those from the ECDC are needed to confirm our results.