Impact of the COVID-19 Pandemic on Multidrug-Resistant Organism Infections in Infected Pancreatic Necrosis: A Post-Hoc Cohort Analysis
Bibliographic record
Abstract
Baiqi Liu,1– 4 Caihong Ning,1– 4 Jiarong Li,1– 4 Zefang Sun,1– 4 Chiayen Lin,1– 4 Xiaoyue Hong,1– 4 Rong Guo,1– 4 Lu Chen,1– 4 Dingcheng Shen,1– 4 Gengwen Huang1– 4 1Department of Pancreatic Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Hernia and Abdominal Wall Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China; 4FuRong Laboratory, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Gengwen Huang, Department of Pancreatic Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China, Email huanggengwen@csu.edu.cnBackground: This study aimed to elucidate the impact of COVID-19 pandemic on multidrug-resistant organism (MDRO) infection in patients with infected pancreatic necrosis (IPN).Methods: This post-hoc analysis of a prospective cohort included patients with IPN stratified into three phases: pre-pandemic (2016– 2019), pandemic period (2020– 2022), and post-pandemic period (2023– 2024). Logistic regression and interrupted time-series analysis (ITSA) were employed to identify risk factors and longitudinal trends.Results: MDRO infection decreased significantly during the pandemic period compared to pre-pandemic levels (44.8% vs 81.1%, P< 0.001). There was no significant difference in the incidence of MDRO infection between the pandemic and post-pandemic period (44.1% vs 44.8%, P=0.924). During the pandemic, both prophylactic antimicrobial usage (64.8% vs 85.1%, P< 0.001) and ICU stays (median: 6.0 vs 15.0 days, P< 0.001) were significantly reduced compared to the pre-pandemic period. Logistic regression identified prophylactic antimicrobial usage (OR 17.28, P< 0.001), ICU stays (OR 1.07, P< 0.001), and the COVID-19 pandemic (OR 0.21, P< 0.001) as independent factors associated with MDRO infection. ITSA revealed a significant decrease in the trend of MDRO infection during the pandemic compared to the pre-pandemic period (P=0.006). An immediate level of MDRO infection increased during the post-pandemic period compared to the pandemic (P=0.040). The similar trend variations were observed in the proportion of prophylactic antimicrobial usage.Conclusion: The COVID-19 pandemic has led to a notable reduction in MDRO infection among IPN patients, likely attributable to stringent infection prevention and control measures which led to reduced prophylactic antimicrobial usage and ICU stays during this period.Keywords: antimicrobial resistance, acute pancreatitis, COVID-19, antimicrobial usage, interrupted time-series analysis
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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 | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".