Carbapenemase-producing organisms under the covid 19 pandemic
Bibliographic record
Abstract
Abstract Background Antibiotic resistance is a widely recognised public health problem. Probably the factor most clearly associated with the emergence of carbapenemase-producing organisms (CPOs) is the use of antimicrobials. During the covid-19 pandemic, most patients with covid-19 received antibiotics. In addition, it is possible that the extra burden of work affected antimicrobial stewardship and infection prevention and control (IPC). The aim of the present study was to investigate the association between the frequency of carbapenemase-producing organisms (CPO) isolates and the excess of workload experienced during the covid-19 pandemic in a regional hospital in south-eastern Spain. Methods Descriptive study. Isolates producing one or more carbapenemases were collected from January 2015 to March 2022. Isolates of the same microorganism were grouped by individual, assuming that they correspond to the same episode of infection or colonisation. To estimate the workload, the rate of admissions of covid-19 cases in intensive care (ICU) and the total number of beds in covid-19 ICU each month were collected. Results The frequency of episodes shows an upward trend since 2018. From the 4th quarter of 2020 there is a clear acceleration until the 2nd quarter of 2021 (20 episodes per month), when a decrease to less than pre-pandemic frequencies is observed (10 episodes per month). The increase in episodes is parallel to the beginning of c ovid-19 admissions observed from the 4th quarter onwards. The decrease of episodes coincides with the increase of bed capacity, even with a maintained rate of admissions. CPO with two carbapenamases occur regularly from the 2nd quarter of 2020. Conclusions The occurrence of CPO may be related to the burden of work in healthcare systems. Disruption of antimicrobial stewardship and IPC could mediate this relationship. The decrease of episodes with a maintained rate of admissions may indicate that antibiotic use is not directly associated with CPO emergence. Key messages • Maintaining healthcare capacities related to antimicrobial stewardship and IPC may be critical in limiting the emergence of CPO. • Antibiotic use may not be directly related to the increase of CPO.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".