2023 journal article

Assessing the impact of the early COVID-19 era on antibiotic resistant threats in inpatient settings: A mixed-Poisson regression approach

American Journal of Infection Control.

By: R. Bloch  n & S. Rhea n 

TL;DR: Despite decreases in C. difficile and most MRSA infections, the early COVID-19 pandemic period saw continued increases in MRSA septicemia admissions in North Carolina, and mean total costs by infection type nearly doubled mean costs among CO VID-19 admissions. (via Semantic Scholar)
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Added: May 26, 2023

{"Label"=>"BACKGROUND", "NlmCategory"=>"BACKGROUND"} During the COVID-19 pandemic, increased antibiotic prescribing and infection prevention challenges coincided with antibiotic-resistant (AR) infection increases. Clostridioides difficile (C difficile) and methicillin-resistant Staphylococcus aureus (MRSA) are serious, costly AR threats. Health inequities in pandemic-era AR infections are not well-characterized. {"Label"=>"METHODS", "NlmCategory"=>"METHODS"} North Carolina statewide inpatient admissions were used to determine monthly admission rates and admission rate ratios (RRs) for C difficile and MRSA infections comparing 2017-2019 (prepandemic) to 2020 (pandemic exposure) using mixed-model Poisson regression adjusted for age, sex, comorbidities, and COVID-19. We assessed effect measure modification by admissions' community-level income, county rurality, and race and ethnicity. Mean total costs by infection type were compared. {"Label"=>"RESULTS", "NlmCategory"=>"RESULTS"} With pandemic exposure, C difficile (adjusted RR = 0.90 [95% confidence interval [CI] 0.86, 0.94]) and MRSA pneumonia (adjusted RR = 0.97 [95% CI 0.91, 1.05]) decreased, while MRSA septicemia (adjusted RR = 1.13 [95% CI 1.07, 1.19]) increased. Effect measure modification was not detected. C difficile or MRSA coinfection nearly doubled mean costs among COVID-19 admissions. {"Label"=>"CONCLUSIONS", "NlmCategory"=>"CONCLUSIONS"} Despite decreases in C difficile and most MRSA infections, the early COVID-19 pandemic period saw continued increases in MRSA septicemia admissions in North Carolina. Equitable interventions to curb increases and reduce health care costs should be developed.