Evidence map›Paper›PMID 37055793›Full record

ArticleAnnals of clinical microbiology and antimicrobials2023

A pandemic within a pandemic? Admission to COVID-19 wards in hospitals is associated with increased prevalence of antimicrobial resistance in two African settings.

Linzy Elton, Muzamil Mahdi Abdel Hamid, John Tembo, Hana Elbadawi, Kwitaka Maluzi, Mohammed H Abdelraheem, Teresa Cullip, Caren Kabanda, Kerry Roulston, Isobella Honeyborne and 12 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of clinical microbiology and antimicrobials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 4 institutions in 3 countries.

Linzy EltonCentre for Clinical Microbiology, University College London, London, UK. linzy.elton@ucl.ac.uk.
Muzamil Mahdi Abdel HamidInstitute for Endemic Diseases, University of Khartoum, Khartoum, Sudan.
John TemboHerpeZ, University Teaching Hospital, Lusaka, Zambia.
Hana ElbadawiInstitute for Endemic Diseases, University of Khartoum, Khartoum, Sudan.
Kwitaka MaluziHerpeZ, University Teaching Hospital, Lusaka, Zambia.
Mohammed H AbdelraheemInstitute for Endemic Diseases, University of Khartoum, Khartoum, Sudan.
Teresa CullipInstitute for Global Health, University College London, London, UK.
Caren KabandaHerpeZ, University Teaching Hospital, Lusaka, Zambia.
Kerry RoulstonCentre for Clinical Microbiology, University College London, London, UK.
Isobella HoneyborneCentre for Clinical Microbiology, University College London, London, UK.
Margaret J ThomasonCentre for Clinical Microbiology, University College London, London, UK.
Kamal ElhagSoba University Hospital, University of Khartoum, Khartoum, Sudan.
Alaelddin MohammedSoba University Hospital, University of Khartoum, Khartoum, Sudan.
Abdelsalam AdamSoba University Hospital, University of Khartoum, Khartoum, Sudan.
Kangwa MulongaHerpeZ, University Teaching Hospital, Lusaka, Zambia.
Kapatiso SikakenaUniversity Teaching Hospitals, Department of Internal Medicine, Infectious Diseases Unit, Lusaka, Zambia.
Peter MatibulaUniversity Teaching Hospitals, Department of Internal Medicine, Infectious Diseases Unit, Lusaka, Zambia.
Mwewa KabasoUniversity Teaching Hospitals, Department of Internal Medicine, Infectious Diseases Unit, Lusaka, Zambia.
Ruth NakazweUniversity Teaching Hospitals, Department of Internal Medicine, Infectious Diseases Unit, Lusaka, Zambia.
Sombo FwoloshiUniversity Teaching Hospitals, Department of Internal Medicine, Infectious Diseases Unit, Lusaka, Zambia.
Alimuddin ZumlaCentre for Clinical Microbiology, University College London, London, UK.
Timothy D McHughCentre for Clinical Microbiology, University College London, London, UK.
University Teaching Hospital · ZMUniversity College London · GBUniversity of Khartoum · SDMRC Clinical Trials Unit at UCL · GB

Funding

British Society for Antimicrobial Chemotherapy BSAC-COVID-77
6 · The paper itself

Abstract

backgroundPatients who develop severe illness due to COVID-19 are more likely to be admitted to hospital and acquire bacterial co-infections, therefore the WHO recommends empiric treatment with antibiotics. Few reports have addressed the impact of COVID-19 management on emergence of nosocomial antimicrobial resistance (AMR) in resource constrained settings. This study aimed to ascertain whether being admitted to a COVID-19 ward (with COVID-19 infection) compared to a non-COVID-19 ward (as a COVID-19 negative patient) was associated with a change in the prevalence of bacterial hospital acquired infection (HAI) species or resistance patterns, and whether there were differences in antimicrobial stewardship (AMS) and infection prevention and control (IPC) guidelines between COVID-19 and non-COVID-19 wards. The study was conducted in Sudan and Zambia, two resource constrained settings with differing country-wide responses to COVID-19.

methodsPatients suspected of having hospital acquired infections were recruited from COVID-19 wards and non-COVID-19 wards. Bacteria were isolated from clinical samples using culture and molecular methods and species identified. Phenotypic and genotypic resistance patterns were determined by antibiotic disc diffusion and whole genome sequencing. Infection prevention and control guidelines were analysed for COVID-19 and non-COVID-19 wards to identify potential differences.

results109 and 66 isolates were collected from Sudan and Zambia respectively. Phenotypic testing revealed significantly more multi-drug resistant isolates on COVID-19 wards in both countries (Sudan p = 0.0087, Zambia p = 0.0154). The total number of patients with hospital acquired infections (both susceptible and resistant) increased significantly on COVID-19 wards in Sudan, but the opposite was observed in Zambia (both p = ≤ 0.0001). Genotypic analysis showed significantly more β-lactam genes per isolate on COVID-19 wards (Sudan p = 0.0192, Zambia p = ≤ 0.0001).

conclusionsChanges in hospital acquired infections and AMR patterns were seen in COVID-19 patients on COVID-19 wards compared to COVID-19 negative patients on non-COVID-19 wards in Sudan and Zambia. These are likely due to a potentially complex combination of causes, including patient factors, but differing emphases on infection prevention and control, and antimicrobial stewardship policies on COVID-19 wards were highlighted.

Indexed as

Bacterial InfectionsCOVID-19Cross InfectionAnti-Bacterial AgentsDrug Resistance, BacterialHospitalsHumansPandemicsPrevalenceAnti-Bacterial AgentsAntimicrobial resistanceAntimicrobial stewardshipCOVID-19Infection prevention and controlMulti-drug resistanceSARS-CoV-2

Identifiers

PMID37055793
PMCPMC10101537
OpenAlexW4365457732

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.