Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards
Abstract
:1. Introduction
2. Results
2.1. Patients
2.2. Cultures
2.3. Mortality
2.4. Antibiotics
3. Discussion
4. Materials and Methods
4.1. Inclusion and Exclusion Criteria
4.2. MDR
4.3. Patient Variables
4.4. Ethical Approval
4.5. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Sample N = 73 | Pre-COVID-19 N = 33 | Post-COVID-19 N = 40 | p | |
---|---|---|---|---|
Age (mean ± SD) | 87.4 ± 5.9 | 88.8 ± 5.9 | 86.1 ± 5.7 | 0.054 |
Male (N, %) | 20 (27.4) | 8 (24.2) | 12 (30.0) | 0.532 |
Functional status (mean ± SD) | ||||
ADL preserved | 1.2 ± 1.6 | 1.3 ± 1.5 | 1.1 ± 1.7 | 0.461 |
IADL preserved | 0.4 ± 1.2 | 0.5 ± 1.3 | 0.3 ± 1.1 | 0.662 |
Mobility (N, %) | 0.934 | |||
Bedridden | 31 (42.5) | 14 (42.4) | 17 (42.5) | |
Bed-chair | 19 (26.0) | 8 (24.2) | 11 (27.5) | |
Walking aid | 20 (27.4) | 10 (30.3) | 10 (25.0) | |
Autonomous | 3 (4.1) | 1 (3.0) | 2 (5.0) | |
Drugs taken daily (mean ± SD) | 6.7 ± 2.8 | 6.3 ± 3.3 | 7.2 ± 2.3 | 0.220 |
Chronic diseases (mean ± SD) | 6.1 ± 2.0 | 6.1 ± 2.2 | 6.1 ± 1.9 | 0.989 |
Reason for admission | 0.188 | |||
Infectious disease (N, %) | 37 (50.7) | 19 (57.6) | 18 (45.0) | |
Other reasons (N, %) | 36 (49.3) | 14 (42.4) | 22 (55.0) | |
Length of stay, days (mean ± SD) | 12.3 ± 7.0 | 11.4 ± 5.8 | 13.0 ± 7.9 | 0.318 |
In-hospital mortality (N, %) | 24 (32.9) | 8 (24.2) | 16 (40.0) | 0.154 |
among MDR infections | 14 (58.3) | 3 (37.5) | 11 (68.8) | 0.198 |
30-days mortality (N, %) | 30 (41.1) | 11 (33.3) | 19 (47.5) | 0.402 |
among MDR infections | 18 (60.0) | 3(27.3) | 15 (78.9) | 0.012 |
Total Positive Cultures N = 83 | Pre-COVID-19 N = 36 | Post-COVID-19 N = 47 | p | |
---|---|---|---|---|
Type of culture(N, %) | ||||
Urinoculture | 62 (74.7) | 31 (86.1) | 31 (66.0) | 0.036 |
Urinoculture with MDR | 33 (53.2) | 16 (51.6) | 17 (54.8) | 0.799 |
Bloodstream culture | 21 (25.3) | 5 (13.9) | 16 (34.0) | 0.036 |
Bloodstream with MDR | 13 (61.9) | 2 (40.0) | 11 (68.8) | 0.038 |
MDR infections(N, %) | 46 (55.4) | 18 (50.0) | 28 (59.6) | 0.384 |
MDR bacteria(N, %) | 0.956 | |||
E. coli | 32 (38.6) | 13 (36.1) | 19 (40.4) | 0.689 |
MDR | 24 (75) | 9 (69.2) | 15 (78.9) | 0.105 |
Klebsiella spp. | 15 (18.1) | 8 (22.2) | 7 (14.9) | 0.390 |
MDR | 7 (46.6) | 4 (50.0) | 3 (42.8) | 0.289 |
Enterococcus spp. | 14 (16.9) | 8 (22.2) | 6 (12.8) | 0.254 |
MDR | 4 (28.6) | 2 (25) | 2 (33.3) | 0.401 |
Proteus spp. | 3 (3.6) | 1 (2.8) | 2 (4.2) | 0.721 |
MDR | 2 (66.7) | 1 (100) | 1 (50) | 0.747 |
Pseudomonas spp. | 7 (8.4) | 3 (8.3) | 4 (8.5) | 0.977 |
MDR | 3 (42.8) | 1 (33.3) | 2 (50) | 0.831 |
Others | 2 (2.4) | 0 (0) | 2 (4.2) | 0.210 |
MDR | 0 (0) | 0 (0) | 0 (0) | - |
Enterobacter spp. | 3 (3.6) | 2 (5.6) | 1 (2.1) | 0.407 |
MDR | 1 (33.3) | 1 (50) | 0 (0) | 0.207 |
Staphylococcus spp. | 7 (8.4) | 1 (2.8) | 6 (12.8) | 0.132 |
MDR | 5 (71.4) | 0 (0) | 5 (83.3) | 0.058 |
MRSA | 1 (1.2) | 0 (0) | 1 (2.1) | 0.482 |
ESBL | 33 (39.8) | 15 (41.7) | 18 (38.3) | 0.705 |
CPB | 9 (10.8) | 3 (8.3) | 6 (12.8) | 0.725 |
Total Positive Cultures N = 83 | Pre-COVID-19 N = 36 | Post-COVID-19 N = 47 | p | |
---|---|---|---|---|
Amikacin | 6 (10.0) | 3 (10.7) | 3 (9.4) | 0.539 |
Amoxicillin/clavulanic | 23 (46.9) | 11 (44.0) | 12 (50.0) | 0.674 |
Ampicillin | 3 (27.3) | 1 (16.7) | 2 (40.0) | 0.387 |
Ampicillin/sulbactam | 3 (27.3) | 1 (16.7) | 2 (40.0) | 0.387 |
Cefepime | 16 (51.7) | 5 (71.4) | 11 (45.8) | 0.259 |
Cefotaxime | 36 (63.2) | 17 (68) | 19 (59.4) | 0.503 |
Ceftazidime | 32 (52.5) | 15 (53.6) | 17 (51.6) | 0.384 |
Ciprofloxacin | 45 (64.3) | 24 (75) | 21 (55.3) | 0.860 |
Clindamycin | 5 (71.4) | 1 (100) | 4 (66.7) | 0.495 |
Erythromycin | 4 (57.1) | 1 (100) | 3 (50.0) | 0.999 |
Ertapenem | 7 (12.3) | 3 (12) | 4 (12.5) | 0.954 |
Fosfomycin | 12 (22.2) | 5 (20.8) | 7 (23.3) | 0.826 |
Fusidic acid | 2 (28.6) | 0 (0) | 2 (33.3) | 0.999 |
Gentamicin | 28 (35.9) | 12 (34.3) | 16 (37.2) | 0.789 |
Imipenem | 3 (27.3) | 1 (16.7) | 2 (40.0) | 0.387 |
Kanamycin | 13 (100) | 6 (100) | 7 (100) | - |
Levofloxacin | 12 (80) | 4 (80) | 8 (80) | 0.999 |
Linezolid | 1 (5.3) | 0 (0) | 1 (8.3) | 0.999 |
Meropenem | 5 (8) | 2 (7.4) | 3 (8.5) | 0.179 |
Nitrofurantoin | 1 (4.0) | 1 (8.3) | 0 (0) | 0.288 |
Oxacillin | 7 (100) | 1 (100) | 6 (100) | - |
Piperacillin/tazobactam | 16 (25.4) | 9 (32.1) | 7 (20.0) | 0.271 |
Rifampicin | 2 (28.6) | 0 (0) | 2 (33.3) | 0.999 |
Streptomycin | 9 (100) | 4 (100) | 5 (100) | - |
Teicoplanin | 3 (16.7) | 1 (14.3) | 2 (18.2) | 0.999 |
Tetracycline | 4 (57.1) | 1 (100) | 3 (50.0) | 0.233 |
Tmt/sulfamethoxazole | 30 (46.9) | 15 (57.7) | 15 (39.5) | 0.118 |
Tigecycline | 2 (3.9) | 1 (5.3) | 1 (3.1) | 0.704 |
Vancomycin | 2 (12.5) | 1 (20) | 1 (9.1) | 0.999 |
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Gasperini, B.; Cherubini, A.; Lucarelli, M.; Espinosa, E.; Prospero, E. Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards. Antibiotics 2021, 10, 95. https://doi.org/10.3390/antibiotics10010095
Gasperini B, Cherubini A, Lucarelli M, Espinosa E, Prospero E. Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards. Antibiotics. 2021; 10(1):95. https://doi.org/10.3390/antibiotics10010095
Chicago/Turabian StyleGasperini, Beatrice, Antonio Cherubini, Moira Lucarelli, Emma Espinosa, and Emilia Prospero. 2021. "Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards" Antibiotics 10, no. 1: 95. https://doi.org/10.3390/antibiotics10010095
APA StyleGasperini, B., Cherubini, A., Lucarelli, M., Espinosa, E., & Prospero, E. (2021). Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards. Antibiotics, 10(1), 95. https://doi.org/10.3390/antibiotics10010095