{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:37:43Z","timestamp":1793061463754,"version":"4.5.0"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21001446_as1\"><jats:title>Objective:<\/jats:title><jats:p>To assess the incidence of colonization and infection with carbapenemase-producing Enterobacteriaceae (CPE) and carbapenem-resistant <jats:italic>Acinetobacter baumannii<\/jats:italic> (CR-Ab) in the ICUs of our city hospitals before and during the coronavirus disease 2019 (COVID-19) pandemic.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21001446_as2\"><jats:title>Methods:<\/jats:title><jats:p>We conducted a multicenter, before-and-after, cross-sectional study to compare the rates of colonization and infection with CPE and\/or CR-Ab in 2 study periods, period 1 (January\u2013April 2019) and period 2 (January\u2013April 2020). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of weekly colonization and infection rates for each period were compared for the 2 study periods using Poisson regression. Weekly trends in the incidence of colonization or infection for each study period were summarized using local weighted (Loess) regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21001446_as3\"><jats:title>Results:<\/jats:title><jats:p>We detected no significant change in either IRR and weekly trend in CPE colonization and infection during the 2 study periods. A shift from KPC to other CPE mechanisms (OXA-48 and VIM) was observed during period 2. Compared to period 1, during period 2 the IRR of colonization and infection with CR-Ab increased 7.5- and 5.5-fold, respectively. Genome sequencing showed that all CR-Ab strains belonged to the CC92\/IC2 clonal lineage. Clinical strains clustered closely into a single monophyletic group in 1 of the 3 centers, whereas they segregated in 2 different clusters in the other 2 centers, which strongly indicates horizontal transmission.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21001446_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Our findings indicate the need to conduct infection control activities targeted against the spread of antimicrobial resistance between and within hospitals during the COVID-19 pandemic, and if necessary, remodulating them according to the new organizational structures imposed by the pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.144","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T09:24:19Z","timestamp":1618565059000},"page":"461-466","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":86,"title":["Carbapenem-resistant bacteria in an intensive care unit during the coronavirus disease 2019 (COVID-19) pandemic: A multicenter before-and-after cross-sectional study"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2687-4235","authenticated-orcid":false,"given":"Renato","family":"Pascale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Bussini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gaibani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bovo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Fornaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Lombardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Ambretti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pensalfine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Appolloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bartoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Tedeschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Tumietto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Viale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Giannella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"S0899823X21001446_ref14","article-title":"Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multihospital cohort study","author":"Vaughn","year":"2020","journal-title":"Clin Infect Dis"},{"key":"S0899823X21001446_ref6","unstructured":"6. Breakpoint tables for interpretation of MICs and zone diameters. Version 11.0, 2020. EUCAST website. http:\/\/www.eucast.org\/clinical_breakpoints\/. Published 2020. Accessed April 4, 2021."},{"key":"S0899823X21001446_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.381"},{"key":"S0899823X21001446_ref8","unstructured":"8. Gagliotti, C , Moro, ML , Carretto, E , et al. Indicazioni pratiche e protocolli operativi per la diagnosi, la sorveglianza e il controllo degli enterobatteri produttori di carbapenemasi nelle strutture sanitarie e socio-sanitarie. Agencia sanitaria e sociale regionale website. 2017. http:\/\/assr.regione.emilia-romagna.it\/it\/servizi\/pubblicazioni\/rapporti-documenti\/indicazioni-pratiche-diagnosi-cpe-2017. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}