Analysis of Bloodstream Infections and Their Antibiotic Sensitivity Pattern (Pre- and Post-COVID Lockdown in an Indian Cancer Hospital): A Record-Based Retrospective Cohort Study
Objectives: In cancer centers, various factors influence the type of organism causing bloodstream infection (BSI). Our premise includes the indirect benefits of hand hygiene of healthcare personnel, masking, and distancing practices during lockdown/post-lockdown period on the type of BSI among cancer patients and their antibiotic sensitivity patterns.
Methods: The retrospective cohort study was conducted from November 2020 to July 2021, among cancer patients admitted to Healthcare Global cancer center. Blood culture reports of patients presenting with symptoms of BSI were retrieved and analyzed in the Department of Preventive Oncology, Healthcare Global. Our data were stratified from pre-lockdown (November 2019 to March 24, 2020) and lockdown/post-lockdown (March 25, 2020, to Jul 2020) periods.
Results: The proportion of culture positives during the pre-lockdown (Nov 2019 to March 24, 2020) and post-lockdown period (March 25, 2020, to July 2020) are 21.7% and 21.1%, respectively. However, this small difference did not show a significant association with the difference in hand hygiene during the two periods (<80% and ≥80%). In our study, Escherichia coli (23.8%), Staphylococcus epidermidis (10.9 %), and Klebsiella pneumoniae (17.8%) were the most common BSI during the pre-lockdown period. A similar analysis during the post-lockdown period shows a higher prevalence of E. coli (20.7%), Staphylococcus haemolyticus (12.1%), and K. pneumoniae (15.5%). In our study, the isolates showed a greater proportion of resistance (>50%) to Gentamicin, Ciprofloxacin, Tigecycline, and Cephalosporin group of drugs.
Conclusion: During COVID times, some of the preventive interventions which were implemented for reducing the transmission of SARS-CoV-2 could contribute to the reduction of BSI in the hospital setting. For the management of BSI, it is imperative to initiate appropriate antimicrobial treatment at an early stage. It is imperative for customizing the antimicrobial stewardship strategies as per the geographic location.
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