Microbiology Clinical Culture Diagnostic Yields and Antimicrobial Resistance Proportions before and during the COVID-19 Pandemic in an Indian Community Hospital and Two US Community Hospitals
Sumanth Gandra,
Gerardo Alvarez-Uria,
Dustin Stwalley,
Katelin B. Nickel,
Kimberly A. Reske,
Jennie H. Kwon,
Erik R. Dubberke,
Margaret A. Olsen,
Jason P. Burnham
Affiliations
Sumanth Gandra
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Gerardo Alvarez-Uria
Department of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, Anantapur 515661, India
Dustin Stwalley
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Katelin B. Nickel
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Kimberly A. Reske
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Jennie H. Kwon
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Erik R. Dubberke
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Margaret A. Olsen
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Jason P. Burnham
Department of Internal Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA
Studies comparing the impact of the COVID-19 pandemic on diagnostic microbiology culture yields and antimicrobial resistance proportions in low-to-middle-income and high-income countries are lacking. A retrospective study using blood, respiratory, and urine microbiology data from a community hospital in India and two community hospitals (Hospitals A and B) in St. Louis, MO, USA was performed. We compared the proportion of cultures positive for selected multi-drug-resistant organisms (MDROs) listed on the WHO’s priority pathogen list both before the COVID-19 pandemic (January 2017–December 2019) and early in the COVID-19 pandemic (April 2020–October 2020). The proportion of blood cultures contaminated with coagulase-negative Staphylococcus (CONS) was significantly higher during the pandemic in all three hospitals. In the Indian hospital, the proportion of carbapenem-resistant (CR) Klebsiella pneumoniae in respiratory cultures was significantly higher during the pandemic period, as was the proportion of CR Escherichia coli in urine cultures. In the US hospitals, the proportion of methicillin-resistant Staphylococcus aureus in blood cultures was significantly higher during the pandemic period in Hospital A, while no significant increase in the proportion of Gram-negative MDROs was observed. Continuity of antimicrobial stewardship activities and better infection prevention measures are critical to optimize outcomes and minimize the burden of antimicrobial resistance among COVID-19 patients.
