Healthcare-related infections before and during the Covid-19 pandemic with Carbapenem-resistant Acinetobacter baumannii

Abstract

Objective: to compare profile of healthcare-related infections (HRI) caused by Carbapenem-resistant Acinetobacter baumannii (CRAb) and to describe the incidence before and after COVID-19 pandemic. Methods: this is a cross-sectional, retrospective study, carried out in a hospital located in Southern Brazil. Data were collected between march, 2019 to December, 2021 from 105 medical records and entries in the local infection control service. Information gathered included sex, age, inpatients diagnosis, site of infection, length of stay until infection, outcome, APACHE II, number of comorbidities, number days with invasive devices, hospitalization days until positive culture, Hospital stays days, colonization, infection treatment and used antibiotic. Results: There were 121 HRI caused by Acinetobacter baumannii. Before the COVID-19 pandemic, the incidence density was 5.73/1000 for ventilator-associated pneumonia and 0.73/1000 for urinary tract infection, while the cumulative incidence was 2.63/100. In the COVID-19 period, the incidence density of ventilator-associated pneumonia was 9.24/1000, 2.04 for urinary tract infection, 0.7/1000 for primary bloodstream infection and the cumulative incidence was 7.64/100. Overall mortality of 57.1% (n=60: 95% CI: 29.5%-62.5%). All isolates were sensitive to Polymyxin. The best outcomes occurred with combination therapy with amikacin Regarding Acinetobacter baumannii infection, the variable days of hospitalization until positive culture (p=0.034) and days of hospitalization (p=0.034) were statistically significant and antibiotics used about the outcome (p=0.069). Conclusion: During the COVID period, there was an increase in the resistance to bacterial infections, in the morbidity and mortality of patients, and the incidence rates of Acinetobacter baumannii infections.