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Microorganisms . Spread of Carbapenem-Resistant Gram-Negatives and Candida auris during the COVID-19 Pandemic in Critically Ill Patients: One Step

tetano

Editor, Senior Moderator
Microorganisms


. 2021 Jan 3;9(1):E95.
doi: 10.3390/microorganisms9010095.
Spread of Carbapenem-Resistant Gram-Negatives and Candida auris during the COVID-19 Pandemic in Critically Ill Patients: One Step Back in Antimicrobial Stewardship?


Laura Magnasco[SUP] 1 [/SUP], Malgorzata Mikulska[SUP] 1 2 [/SUP], Daniele Roberto Giacobbe[SUP] 1 2 [/SUP], Lucia Taramasso[SUP] 1 [/SUP], Antonio Vena[SUP] 1 [/SUP], Chiara Dentone[SUP] 1 [/SUP], Silvia Dettori[SUP] 2 [/SUP], Stefania Tutino[SUP] 2 [/SUP], Laura Labate[SUP] 2 [/SUP], Vincenzo Di Pilato[SUP] 3 [/SUP], Francesca Crea[SUP] 4 [/SUP], Erika Coppo[SUP] 3 4 [/SUP], Giulia Codda[SUP] 3 [/SUP], Chiara Robba[SUP] 5 [/SUP], Lorenzo Ball[SUP] 3 5 [/SUP], Nicolo' Patroniti[SUP] 3 5 [/SUP], Anna Marchese[SUP] 3 4 [/SUP], Paolo Pelosi[SUP] 3 5 [/SUP], Matteo Bassetti[SUP] 1 2 [/SUP]



Affiliations

Abstract

The possible negative impact of severe adult respiratory distress caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection (COVID-19) on antimicrobial stewardship and infection control has been postulated, but few real-life data are available. The aim of this study was to report our experience with colonization/infection of carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Klebsiella pneumoniae (CR-Kp) and Candida auris among critically ill COVID-19 patients admitted to the intensive care unit (ICU). All COVID-19 patients admitted to the ICUs at San Martino Policlinico Hospital-IRCCS in Genoa, Italy, were screened from 28 February to 31 May 2020. One-hundred and eighteen patients admitted to COVID-19 ICUs were included in the study. Among them, 12 (10.2%) became colonized/infected with CRPA, 6 (5.1%) with C. auris and 2 (1.6%) with CR-Kp. All patients with CRPA received prior treatment with meropenem, and in 11 (91.7%) infection was not preceded by colonization. Four patients (66.7%) developed C. auris candidemia. A significant spread of resistant pathogens was observed among critically ill COVID-19 patients. Dedicated strategies are warranted to prevent horizontal spread and maintain effective antimicrobial stewardship programs in the setting of COVID-19 care.

Keywords: Candida auris; Klebsiella pneumoniae; Pseudomonas aeruginosa; antimicrobial resistance; carbapenem-resistance; intensive care.
 
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