Zhu, Nina J, Rawson, Timothy M 
ORCID: 0000-0002-2630-9722, Mookerjee, Siddharth, Price, James R, Davies, Frances, Otter, Jonathan, Aylin, Paul, Hope, Russell, Gilchrist, Mark, Shersing, Yeeshika et al (show 1 more authors)
(2022)
Changing Patterns of Bloodstream Infections in the Community and Acute Care Across 2 Coronavirus Disease 2019 Epidemic Waves: A Retrospective Analysis Using Data Linkage.
CLINICAL INFECTIOUS DISEASES, 75 (1).
E1082-E1091.
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Abstract
<h4>Background</h4>We examined community- and hospital-acquired bloodstream infections (BSIs) in coronavirus disease 2019 (COVID-19) and non-COVID-19 patients across 2 epidemic waves.<h4>Methods</h4>We analyzed blood cultures of patients presenting to a London hospital group between January 2020 and February 2021. We reported BSI incidence, changes in sampling, case mix, healthcare capacity, and COVID-19 variants.<h4>Results</h4>We identified 1047 BSIs from 34 044 blood cultures, including 653 (62.4%) community-acquired and 394 (37.6%) hospital-acquired. Important pattern changes were seen. Community-acquired Escherichia coli BSIs remained below prepandemic level during COVID-19 waves, but peaked following lockdown easing in May 2020, deviating from the historical trend of peaking in August. The hospital-acquired BSI rate was 100.4 per 100 000 patient-days across the pandemic, increasing to 132.3 during the first wave and 190.9 during the second, with significant increase in elective inpatients. Patients with a hospital-acquired BSI, including those without COVID-19, experienced 20.2 excess days of hospital stay and 26.7% higher mortality, higher than reported in prepandemic literature. In intensive care, the BSI rate was 421.0 per 100 000 intensive care unit patient-days during the second wave, compared to 101.3 pre-COVID-19. The BSI incidence in those infected with the severe acute respiratory syndrome coronavirus 2 Alpha variant was similar to that seen with earlier variants.<h4>Conclusions</h4>The pandemic have impacted the patterns of community- and hospital-acquired BSIs, in COVID-19 and non-COVID-19 patients. Factors driving the patterns are complex. Infection surveillance needs to consider key aspects of pandemic response and changes in healthcare practice.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | healthcare-associated infection, bacteremia, antimicrobial resistance, SARS-CoV-2 |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 18 Oct 2022 15:36 |
| Last Modified: | 18 Jan 2023 19:49 |
| DOI: | 10.1093/cid/ciab869 |
| Open Access URL: | https://doi.org/10.1093/cid/ciab869 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165634 |
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