投稿分類 抗生素管制

主委發表種類: 口頭

投稿標題(中): 2019至2023年間COVID-19疫情對國內抗生素抗藥性之影響

投稿標題(英): The impacts of COVID-19 on the antimicrobial resistance in Taiwan, 2019 – 2023

投稿摘要(前言): The COVID-19 pandemic has strained the healthcare systems to compromise the capacities to implement infection prevention and control (IPC) measures and antimicrobial stewardship programs (ASP), which consequently led to increased antimicrobial resistance (AMR). We aimed to assess the impacts of the COVID-19 pandemic on the incidences and proportions of multi-drug resistant pathogens (MDROs) in Taiwan.

投稿摘要(方法): Taiwan CDC conducted national AMR surveillance in 2017 on voluntary and isolates-based report. We obtained incidence and proportion data on carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus faecium (VREf) from 2019 to 2023. We categorized the study period into 3 phases: (1) pre-pandemic phase (the 1st quarter of 2019 to the 1st quarter of 2020) when there was no COVID-19 epidemic in the community; (2) containment phase (the 2nd quarter of 2020 to the 1st quarter of 2022) marked by low community prevalence of COVID-19 and stringent containment and IPC policies; (3) mitigation phase (the 2nd quarter of 2022 to the 4th quarter of 2023) with a prevalent community epidemic and a shift in response strategies towards mitigation and relaxed IPC measures. We compared the incidence densities and proportions of the pathogens in containment phase and mitigation phase to those in pre-pandemic phase by linear regression analysis.

投稿摘要(結果): During the study period, the mean incidence densities of CRKP, CRPA, CRAB, MRSA, and VREf were 0.58, 0.49, 0.78, 0.86, and 0.64 cases per 1,000 inpatient days, respectively. The mean proportions of CRKP, CRPA, CRAB, MRSA, and VREf were 15.45%, 14.56%, 61.74%. 47.03% and 56.41% respectively. Except for VREf, the incidence densities decreased during the containment phase by 0.03 cases per 1,000 inpatient days for CRKP, 0.04 cases per 1,000 inpatient days for CRPA, 0.11 cases per 1,000 inpatient days for CRAB, and 0.26 cases per 1,000 inpatient days for MRSA compared to those during the pre-pandemic phase (all P < 0.05). During the mitigation phase, the incidence densities for MRSA decreased by 0.29 cases per 1,000 inpatient days, while the incidence density for VRE increased by 0.06 cases per 1,000 inpatient days (both P < 0.05). The proportions of CRPA increased by 1.22% during the containment phase and 1.80% during the mitigation phase, while the proportions of MRSA decreased during the containment phase by 4.21% and the mitigation phase by 5.27% (all P < 0.05).

投稿摘要(討論): These findings implicated that the stringent IPC measures might be helpful in reducing the incidences of MDROs, with limited effects on their proportions. The COVID-19 pandemic posed heterogeneous impacts of on different MDROs in Taiwan. We recommend to strengthen health system resiliency on sustainable AMR surveillance, IPC, and ASP to withstand the future pandemic.

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