Abstract
Background: We examined community- and hospital-acquired bloodstream infections (BSIs) in coronavirus disease 2019 (COVID-19) and non-COVID-19 patients across 2 epidemic waves.
Methods: 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.
Results: 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.
Conclusions: 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.
Keywords: SARS-CoV-2; antimicrobial resistance; bacteremia; healthcare-associated infection.
【저자키워드】 SARS-CoV-2, antimicrobial resistance, Bacteremia, healthcare-associated infection., 【초록키워드】 COVID-19, coronavirus disease, Coronavirus disease 2019, coronavirus, pandemic, Mortality, intensive care, lockdown, hospital, Infection, severe acute respiratory syndrome Coronavirus, variants, antimicrobial resistance, Epidemic, Culture, Surveillance, healthcare, Patient, Community, sampling, second wave, Alpha variant, incidence, London, First wave, change, bloodstream infection, Blood, Bacteremia, Escherichia coli, Bloodstream infections, Hospital stay, case mix, Inpatients, acute respiratory syndrome, Factor, Non-COVID-19 patients, acute respiratory syndrome coronavirus, significant increase, complex, cultures, driving, BSI, peaking, analyzed, examined, reported, peaked, remained, changes in, presenting, impacted, non-COVID-19 patient, 【제목키워드】 pattern, linkage, Changing,