Surging bloodstream infections and antimicrobial resistance during the first wave of COVID–19: a study in a large multihospital institution in the Paris region
Rishma Amarsy, D. Trystram, Emmanuelle Cambau, Catherine Monteil, Sandra Fournier, J. Oliary, Helga Junot, Pierre Sabatier, Raphaël Porcher, J. Robert, Vincent Jarlier, Guillaume Arlet, Laurence Armand-Lefèvre, Alexandra Aubry, Laurent Bélec, Béatrice Berçot, Stéphane Bonacorsi, Vincent Cálvez, Emmanuelle Cambau, Étienne Carbonnelle, Stéphane Chevaliez, Jean‐Winoc Decousser, Constance Delaugerre, Diane Descamps, Florence Doucet‐Populaire, Jean-Louis Gaillard, Antoine Garbarg- Chenon, Elyanne Gault, Jean‐Louis Herrmann, Vincent Jarlier, Jérôme Le Goff, Jean‐Christophe Lucet, Jean‐Luc Mainardi, Anne-Geneviève Marcellin, Laurence Morand‐Joubert, Xavier Nassif, Jean–Michel Pawlotsky, J. Robert, Anne‐Marie Roque Afonso, Martin Rottman, Christine Rouzioux, Flore Rozenberg, François Simon, Nicolas Véziris, David Skurnik, Jean‐Ralph Zahar, Guilène Barnaud, Typhaine Billard Pomares, Gaëlle Cuzon, Dominique Decré, Alexandra Doloy, Jean‐Luc Donay, Laurence Drieux-Rouzet, Isabelle Durand, Agnès Ferroni, Vincent Fihman, Nicolas Fortineau, Camille Gomart, Nathalie Grall, Christelle Guillet Caruba, Françoise Jauréguy, V. Lalande, Luce Landraud, Véronique Leflon, Patricia Mariani, Liliana Mihaila, Didier Moissenet, Latifa Noussair, Isabelle Podglajen, I. Poîlane, Hélène Poupet, Emilie Rondinaud, Valérie Sivadon Tardy, D. Trystram, Charlotte Verdet, Emmanuelle Vigier, Sophie Vimont Billarant
Abstract
OBJECTIVES: This study measured the impact of the first wave of COVID-19 pandemic (COVID-19) (March-April 2020) on the incidence of bloodstream infections (BSIs) at Assistance Publique - Hôpitaux de Paris (APHP), the largest multisite public healthcare institution in France. METHODS: The number of patient admission blood cultures (BCs) collected, number of positive BCs, and antibiotic resistance and consumption were analysed retrospectively for the first quarter of 2020, and also for the first quarter of 2019 for comparison, in 25 APHP hospitals (ca. 14 000 beds). RESULTS: Up to a fourth of patients admitted in March-April 2020 in these hospitals had COVID-19. The BSI rate per 100 admissions increased overall by 24% in March 2020 and 115% in April 2020, and separately for the major pathogens (Escherichia coli, Klebsiella pneumoniae, enterococci, Staphylococcus aureus, Pseudomonas aeruginosa, yeasts). A sharp increase in the rate of BSIs caused by microorganisms resistant to third-generation cephalosporins (3GC) was also observed in March-April 2020, particularly in K. pneumoniae, enterobacterial species naturally producing inducible AmpC (Enterobacter cloacae...), and P. aeruginosa. A concomitant increase in 3GC consumption occurred. CONCLUSIONS: The COVID-19 pandemic had a strong impact on hospital management and also unfavourable effects on severe infections, antimicrobial resistance, and laboratory work diagnostics.