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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Thoma, Reto Seneghini, Marco Seiffert, Salomé N. Vuichard Gysin, Danielle Scanferla, Giulia Haller, Sabine Flury, Domenica Boggian, Katia Kleger, Gian-Reto Filipovic, Miodrag Nolte, Oliver Schlegel, Matthias Kohler, Philipp |
| Abstract | Background Despite the adoption of strict infection prevention and control measures, many hospitals have reported outbreaks of multidrug-resistant organisms (MDRO) during the Coronavirus 2019 (COVID-19) pandemic. Following an outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in our institution, we sought to systematically analyse characteristics of MDRO outbreaks in times of COVID-19, focussing on contributing factors and specific challenges in controlling these outbreaks. Methods We describe results of our own CRAB outbreak investigation and performed a systematic literature review for MDRO (including Candida auris) outbreaks which occurred during the COVID-19 pandemic (between December 2019 and March 2021). Search terms were related to pathogens/resistance mechanisms AND COVID-19. We summarized outbreak characteristics in a narrative synthesis and contrasted contributing factors with implemented control measures. Results The CRAB outbreak occurred in our intensive care units between September and December 2020 and comprised 10 patients (thereof seven with COVID-19) within two distinct genetic clusters (both ST2 carrying OXA-23). Both clusters presumably originated from COVID-19 patients transferred from the Balkans. Including our outbreak, we identified 17 reports, mostly caused by Candida auris (n = 6) or CRAB (n = 5), with an overall patient mortality of 35% (68/193). All outbreaks involved intensive care settings. Non-adherence to personal protective equipment (PPE) or hand hygiene (n = 11), PPE shortage (n = 8) and high antibiotic use (n = 8) were most commonly reported as contributing factors, followed by environmental contamination (n = 7), prolonged critical illness (n = 7) and lack of trained HCW (n = 7). Implemented measures mainly focussed on PPE/hand hygiene audits (n = 9), environmental cleaning/disinfection (n = 9) and enhanced patient screening (n = 8). Comparing potentially modifiable risk factors and control measures, we found the largest discrepancies in the areas of PPE shortage (risk factor in 8 studies, addressed in 2 studies) and patient overcrowding (risk factor in 5 studies, addressed in 0 studies). Conclusions Reported MDRO outbreaks during the COVID-19 pandemic were most often caused by CRAB (including our outbreak) and C. auris. Inadequate PPE/hand hygiene adherence, PPE shortage, and high antibiotic use were the most commonly reported potentially modifiable factors contributing to the outbreaks. These findings should be considered for the prevention of MDRO outbreaks during future COVID-19 waves. |
| Related Links | https://aricjournal.biomedcentral.com/counter/pdf/10.1186/s13756-022-01052-8.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 20472994 |
| DOI | 10.1186/s13756-022-01052-8 |
| Journal | Antimicrobial Resistance & Infection Control |
| Issue Number | 1 |
| Volume Number | 11 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-01-21 |
| Access Restriction | Open |
| Subject Keyword | Medical Microbiology Drug Resistance Infectious Diseases COVID-19 Multidrug-resistant organisms Outbreaks Review |
| Content Type | Text |
| Resource Type | Review |
| Subject | Public Health, Environmental and Occupational Health Infectious Diseases Microbiology (medical) Pharmacology (medical) |
| Journal Impact Factor | 4.8/2023 |
| 5-Year Journal Impact Factor | 5.8/2023 |
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