Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R² = 0.980, p = 0.01) and carbapenems (R² = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

中文翻译：

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COVID-19 对成人重症监护病房医院获得性感染情况的影响

医院获得性感染 (HAI) 是一个全球性的公共卫生问题。随着 COVID-19 大流行的继续，其对死亡率和抗菌素耐药性 (AMR) 的贡献增加，特别是在重症监护病房 (ICU) 中。2019 年 4 月至 2021 年 4 月在塞尔维亚贝尔格莱德传染病和热带疾病医院的成人重症监护病房进行了一项为期两年的回顾性研究，以评估 HAI 和 AMR 发生率的病原体，而 COVID-19 大流行随后发生在塞尔维亚贝尔格莱德的中途。学习。对大多数测试的抗微生物药物观察到了 >80% 的耐药率。在 COVID-19 患者中，不动杆菌属。是 HAI 的主要原因，并且比非 COVID-19 患者更常被孤立。（67 对 18，p = 0.001）。此外，亚胺培南的耐药性更高（56.8% 对 24.5%，p < 0.001）、美罗培南（61.1% 对 24.3%，p < 0.001）和环丙沙星（59.5% 对 36.9%，p = 0.04）。AMR 率与我们之前研究的结果相结合，以确定耐药趋势并建立经验性治疗建议。不动杆菌属的存在增加。和克雷伯菌属的积极趋势。对氟喹诺酮类（R ² = 0.980，p = 0.01）和碳青霉烯类（R ² = 0.963，p= 0.02) 可能导致血流感染 (BSI)、肺炎 (PN) 和尿路感染 (UTI) 的耐药率令人担忧。BSI 中万古霉素 (16.0%) 和利奈唑胺 (2.6%) 除外；PNs 中的替加环素 (14.3%) 和粘菌素 (0%)；UTI 中的粘菌素 (12.0%) 和利奈唑胺 (0%)。COVID-19 改变了我们 ICU 中 HAI 的格局。迫切需要批准新药和严格监测。