Antibiotics (Feb 2021)

Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

  • Bernardo A. Martinez-Guerra,
  • Maria F. Gonzalez-Lara,
  • Nereyda A. de-Leon-Cividanes,
  • Karla M. Tamez-Torres,
  • Carla M. Roman-Montes,
  • Sandra Rajme-Lopez,
  • G. Ivonne Villalobos-Zapata,
  • Norma I. Lopez-Garcia,
  • Areli Martínez-Gamboa,
  • Jose Sifuentes-Osornio,
  • Edgar Ortiz-Brizuela,
  • Eric Ochoa-Hein,
  • Arturo Galindo-Fraga,
  • Miriam Bobadilla-del-Valle,
  • Alfredo Ponce-de-León

DOI
https://doi.org/10.3390/antibiotics10020182
Journal volume & issue
Vol. 10, no. 2
p. 182

Abstract

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Objective: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. Methods: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. Results: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p Enterobacteriaceae and coagulase negative staphylococci, respectively.

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