{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T06:10:53Z","timestamp":1775542253410,"version":"3.50.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":[".82302450, 82271628"],"award-info":[{"award-number":[".82302450, 82271628"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multidrug-resistant organism (MDRO) infections are a major global health threat. The COVID-19 pandemic and related containment policies may have altered hospital infection epidemiology and the distribution of MDROs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, clinical and microbiological data from 2,669 adult inpatients with culture-confirmed hospital-acquired infections between 2013 and 2023 were analyzed. MDROs were defined per CLSI guidelines. The study period was stratified into pre-pandemic, strict containment, and post-adjustment phases. Multivariate logistic regression was used to identified factors associated with specific MDRO infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall MDRO detection rate increased from 36.9% to 56.4% during the strict containment. CRAB, which had previously been the dominant resistant pathogen, was progressively overtaken by CRE, while\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      became the predominant species in 2022 (40.0%).Bloodstream infections increased from a pre-pandemic peak of 24% to 32% during the strict containment phase. Male sex, age\u226560 years, and prolonged hospitalization (&amp;gt;14 days) were associated with distinct distribution patterns of CRAB and CRE infection. In multivariable analyses, mechanical ventilation was associated with increased odds of CRAB infection (aOR=2.07, 95% CI: 1.36-3.16), while urinary catheter use was associated with increased odds of CRE infection (aOR=1.49, 95% CI: 1.06-2.09) but lower odds of CRAB infection (aOR=0.64, 95% CI: 0.46-0.89). Endotracheal intubation was associated with increased odds of VRE infection (aOR = 5.84, 95% CI: 1.10-30.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospital MDRO epidemiology shifted substantially across the COVID-19 policy phases, with CRE emerging as the dominant resistant pathogen. Specific invasive procedures showed pathogen-specific associations, supporting risk stratification and more targeted infection prevention strategies in high-risk hospitalized patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1786780","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:28:40Z","timestamp":1775539720000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology and risk factors of multidrug-resistant organisms in a Chinese tertiary hospital: a 10-year retrospective cohort study across the COVID-19 policy phases, 2013\u20132023"],"prefix":"10.3389","volume":"16","author":[{"given":"Shanshan","family":"Yang","sequence":"first","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]},{"name":"Department of Disease Prevention and Control, The 1st Medical Center, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Wei","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haixu","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazhuo","family":"Hu","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The 2nd Medical Center, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingjian","family":"Cao","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xintong","family":"Nie","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Qiu","sequence":"additional","affiliation":[{"name":"Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People\u2019s Liberation Army (PLA) General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.jiph.2022.12.022","article-title":"Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: a systematic review","volume":"16","author":"Abubakar","year":"2023","journal-title":"J. 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