Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalised patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Methods: Data on NDM-CRE patients hospitalised in five Tuscan hospitals were collected from 01/2019 to 12/2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multivariate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Results: Since March 2020 an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonisation, ICU stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital days in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Conclusions: Our data suggest a resurgence in NDM-CRE spread among hospitalised patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.

Trends in hospital acquired NDM-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic

Arzilli, Guglielmo;Barnini, Simona;Pistello, Mauro;Baggiani, Angelo;Privitera, Gaetano;Tavoschi, Lara
;
Porretta, Andrea
2023-01-01

Abstract

Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalised patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Methods: Data on NDM-CRE patients hospitalised in five Tuscan hospitals were collected from 01/2019 to 12/2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multivariate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Results: Since March 2020 an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonisation, ICU stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital days in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Conclusions: Our data suggest a resurgence in NDM-CRE spread among hospitalised patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.
2023
Arzilli, Guglielmo; Forni, Silvia; Righi, Lorenzo; Barnini, Simona; Petricci, Patrizia; Parisio, Eva Maria; Pistello, Mauro; Vivani, Paola; Gemignani,...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/1176241
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