Publication:
Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella pneumoniae Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis

Simple item page
dc.contributor.authorAllel, Kasim
dc.contributor.authorPeters, Anne Sophie
dc.contributor.authorConejeros, José
dc.contributor.authorMartínez, José
dc.contributor.authorSpencer, Maria
dc.contributor.authorRiquelme, Roberto
dc.contributor.authorRivas Jiménez, Lina María
dc.contributor.authorRojas, Pamela
dc.contributor.authorOrellana, Cristian
dc.contributor.authorGarcía, Patricia
dc.contributor.authorAraos Bralic, Rafael Ignacio
dc.contributor.authorMcGovern, Olivia
dc.contributor.authorPatel, Twisha
dc.contributor.authorArias, Cesar
dc.contributor.authorLessa, Fernanda
dc.contributor.authorUndurraga, Eduardo
dc.contributor.authorMunita, Jose M.
dc.date.accessioned2024-05-08T15:40:24Z
dc.date.available2024-05-08T15:40:24Z
dc.date.issued2023
dc.description.abstractBackground: The impact of coronavirus disease 2019 (COVID-19) on antimicrobial use (AU) and resistance has not been well evaluated in South America. These data are critical to inform national policies and clinical care. Methods: At a tertiary hospital in Santiago, Chile, between 2018 and 2022, subdivided into pre- (3/2018-2/2020) and post-COVID-19 onset (3/2020-2/2022), we evaluated intravenous AU and frequency of carbapenem-resistant Enterobacterales (CRE). We grouped monthly AU (defined daily doses [DDD]/1000 patient-days) into broad-spectrum β-lactams, carbapenems, and colistin and used interrupted time-series analysis to compare AU during pre- and post-pandemic onset. We studied the frequency of carbapenemase-producing (CP) CRE and performed whole-genome sequencing analyses of all carbapenem-resistant (CR) Klebsiella pneumoniae (CRKpn) isolates collected during the study period. Results: Compared with pre-pandemic, AU (DDD/1000 patient-days) significantly increased after the pandemic onset, from 78.1 to 142.5 (P < .001), 50.9 to 110.1 (P < .001), and 4.1 to 13.3 (P < .001) for broad-spectrum β-lactams, carbapenems, and colistin, respectively. The frequency of CP-CRE increased from 12.8% pre-COVID-19 to 51.9% after pandemic onset (P < .001). The most frequent CRE species in both periods was CRKpn (79.5% and 76.5%, respectively). The expansion of CP-CRE harboring blaNDM was particularly noticeable, increasing from 40% (n = 4/10) before to 73.6% (n = 39/53) after pandemic onset (P < .001). Our phylogenomic analyses revealed the emergence of two distinct genomic lineages of CP-CRKpn: ST45, harboring blaNDM, and ST1161, which carried blaKPC. Conclusions: AU and the frequency of CP-CRE increased after COVID-19 onset. The increase in CP-CRKpn was driven by the emergence of novel genomic lineages. Our observations highlight the need to strengthen infection prevention and control and antimicrobial stewardship efforts.
dc.description.versionPublicada
dc.identifier.citationAllel K, Peters A, Conejeros J, Martínez JRW, Spencer-Sandino M, Riquelme-Neira R, Rivas L, Rojas P, Orellana Chea C, García P, Araos R, McGovern O, Patel TS, Arias CA, Lessa FC, Undurraga EA, Munita JM. Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella pneumoniae Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S20-S28. doi: 10.1093/cid/ciad151
dc.identifier.doihttps://doi.org/10.1093/cid/ciad151
dc.identifier.urihttps://hdl.handle.net/11447/8725
dc.language.isoen
dc.subjectAntibiotic consumption
dc.subjectAntimicrobial resistance
dc.subjectCOVID-19
dc.subjectCarbapenemase-producing organisms.
dc.titleAntibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella pneumoniae Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceClinical infectious diseases : an official publication of the Infectious Diseases Society of America
dspace.entity.typePublication
relation.isAuthorOfPublication9aa6c0c0-19d6-4242-bf19-072f65ee8b0b
relation.isAuthorOfPublication2bf16b44-04d3-45fe-8dd0-dafa6322ca94
relation.isAuthorOfPublication69e40056-7a55-41b3-8a65-05aace0e07e3
relation.isAuthorOfPublicationec52b0bf-d0bc-4844-9531-eca4a65f2b8e
relation.isAuthorOfPublication.latestForDiscovery9aa6c0c0-19d6-4242-bf19-072f65ee8b0b

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella.pdf
Size:
745.77 KB
Format:
Adobe Portable Document Format
Description:
Texto Completo
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
347 B
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services