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SG-APSIC1097: The impact of COVID-19 on the incidence of carbapenem-resistant Enterobacterales (CRE) in Singapore: An interrupted time-series analysis

Authors :
Chong Hui Clara Ong
Thoon Koh Cheng
Surinder Kaur M S Pada
Deepak Rama Narayana
Say Tat Ooi
Nares Smitasin
Kok Choon Raymond Fong
Tse Hsien Koh
Pei Zhi Benjamin Cherng
Raymond Lin
De Partha Pratim
Hsu Li Yang
Jeanette Teo
Oon Tek Ng
Indumathi Venkatachalam
Kalisvar Marimuthu
Source :
Antimicrobial Stewardship & Healthcare Epidemiology, Vol 3, Pp s24-s24 (2023)
Publication Year :
2023
Publisher :
Cambridge University Press, 2023.

Abstract

Objectives: Over the past 2 years, many infection prevention and control (IPC) resources have been diverted to manage the COVID-19 pandemic. Its impact on the incidence of antimicrobial-resistant organisms has not been adequately studied. We investigated the impact of the pandemic on the incidence of carbapenem-resistant Enterobacterales (CRE) in Singapore. Methods: We extracted data on unique CRE isolates (clinical and/or surveillance cultures) and patient days for 6 public hospitals in Singapore from the carbapenemase-producing Enterobacteriaceae (CaPES) study group database, and we calculated the monthly incidence of CRE (per 10,000 patient days). Interrupted time-series (ITS) analysis was conducted with the pre–COVID-19 period defined as before February 2020, and the COVID-19 period defined as after February 2020. Statistical analyses were performed using Stata version 15 software. Results: From January 2017 to March 2021, 6,770 CRE isolates and 9,126,704 patient days were documented. The trend in CRE monthly incidence increased significantly during the pre–COVID-19 period (0.060; 95% CI, 0.033–0.094; P < .001) but decreased during the COVID-19 period (−0.183; 95% CI, −0.390 to 0.023; P = .080) without stepwise change in the incidence (−1.496; 95% CI, −3.477 to 0.485; P = .135). The trend in monthly incidence rate of CRE clinical cultures increased significantly during the pre–COVID-19 period (0.046; 95% CI, 0.028–0.064; P < .001) and decreased significantly during COVID-19 period (−0.148; 95% CI, −0.249 to −0.048; P = .048) with no stepwise change in the incidence (−0.063; 95% CI, −0.803 to 0.677; P = .864). The trend in monthly incidence rate of CRE surveillance cultures decreased during the pre–COVID-19 period (−0.020; 95% CI, −0.062 to 0.022; P = .341) and the COVID-19 period (−0.067; 95% CI, −0.291to 0.158; P = .552) without stepwise change in the incidence (−1.327; 95% CI, −3.535 to 0.881; P = .233). Conclusions: The rate of CRE in clinical cultures decreased during COVID-19 but not the rate in surveillance cultures. Further studies are warranted to study the impact of COVID-19 on CREs.

Details

Language :
English
ISSN :
2732494X
Volume :
3
Database :
Directory of Open Access Journals
Journal :
Antimicrobial Stewardship & Healthcare Epidemiology
Publication Type :
Academic Journal
Accession number :
edsdoj.83e84afac44f4d5cbb54fde4d342d748
Document Type :
article
Full Text :
https://doi.org/10.1017/ash.2023.72