Impact of COVID-19 on acquisitions of multi-drug-resistant organisms in a tertiary intensive care unit: A single center retrospective observational study

Abstract

Background: The coronavirus disease (COVID-19) has resulted in more than 6 million deaths worldwide since it was identified in 2019, resulting in significant morbidity and mortality. The impact of COVID-19 on the acquisition of multi-drug-resistant organisms (MDRO) remains uncertain. This study aims to investigate the effect of COVID-19 on the acquisition of MDRO in the intensive care unit (ICU). Methods: A single-center, retrospective observational study at Wollongong ICU compared the acquisition rate of MDRO, especially vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA), pre- and post-COVID. Results: There was a significant increase in MDRO incidence post-COVID compared to pre-COVID, with incidence rates increasing from 1.6% to 4.56%, especially in MRSA acquisitions, which increased from 0.91% to 5.71%. This increase was associated with a longer ICU length of stay (LOS) but did not have a significant effect on hospital LOS or mortality. The increased incidence of MDRO was potentially related to increased antibiotic use and staffing changes during the COVID period. Conclusion: COVID-19 significantly impacted the acquisition of MDRO, particularly MRSA. Keywords: Coronavirus disease, multi-drug-resistant organisms, methicillin-resistant Staphylococcus aureus, intensive care unit, vancomycin-resistant enterococci