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- Title
Impact of Antibiotic Consumption on the Acquisition of Extended-Spectrum β-Lactamase Producing Enterobacterales Carriage during the COVID-19 Crisis in French Guiana.
- Authors
Lontsi Ngoula, Guy; Houcke, Stéphanie; Matheus, Séverine; Nkontcho, Flaubert; Pujo, Jean Marc; Higel, Nicolas; Ba, Absettou; Cook, Fabrice; Gourjault, Cyrille; Mounier, Roman; Nacher, Mathieu; Demar, Magalie; Djossou, Felix; Hommel, Didier; Kallel, Hatem
- Abstract
(1) Background: During the COVID-19 outbreak, several studies showed an increased prevalence of extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE) carriage in intensive care units (ICUs). Our objective was to assess the impact of antibiotic prescriptions on the acquisition of ESBL-PE in ICUs during the COVID-19 crisis. (2) Methods: We conducted an observational study between 1 April 2020, and 31 December 2021, in the medical-surgical ICU of the Cayenne General Hospital. We defined two periods: Period 1 with routine, empirical antibiotic use, and Period 2 with no systematic empiric antibiotic prescription. (3) Results: ICU-acquired ESBL-PE carriage was 22.8% during Period 1 and 9.4% during Period 2 (p = 0.005). The main isolated ESBL-PE was Klebsiella pneumoniae (84.6% in Period 1 and 58.3% in Period 2). When using a generalized linear model with a Poisson family, exposure to cefotaxime was the only factor independently associated with ESBL-PE acquisition in ICU (p = 0.002, IRR 2.59 (95% IC 1.42–4.75)). The propensity scores matching estimated the increased risk for cefotaxime use to acquire ESBL-PE carriage at 0.096 (95% CI = 0.02–0.17), p = 0.01. (4) Conclusions: Exposure to cefotaxime in patients with severe COVID-19 is strongly associated with the emergence of ESBL-PE in the context of maximal infection control measures.
- Subjects
FRENCH Guiana; COVID-19 pandemic; COVID-19; ANTIBIOTICS; CEFOTAXIME; PROPENSITY score matching
- Publication
Antibiotics (2079-6382), 2023, Vol 12, Issue 1, p58
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics12010058