Impact of COVID-19 Pandemic on carbapenem-resistant Enterobacteriaceae bloodstream infection: a single-center study in China

Authors

  • Lian Xu Department of Internal Medicine, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
  • Changcheng Shi Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China
  • Shelan Liu Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
  • Shuying Wang Department of Hospital Infection Management, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China

DOI:

https://doi.org/10.3855/jidc.21495

Keywords:

Drug resistant, multiple resistant bacteria, carbapenem-resistant Enterobacteriaceae, COVID-19

Abstract

Introduction: The problem of carbapenem resistance in Enterobacteriaceae is becoming increasingly serious, and Carbapenem-Resistant Enterobacteriaceae (CRE) has become a major problem in clinical infection, especially in intensive care units (ICU). The purpose of the study is to explore the impact of the occurrence of COVID-19 on the bloodstream infection of CRE (CRE-BSI) and carbapenem resistance.

Methodology: In this study, adult patients with CRE-BSI from January 2019 to January 2023 were collected to perform a single-center cross-sectional study, who were divided into pre-COVID-19, COVID-19 until \"New Ten\" (only accept non-COVID-19 patients), and post-\"New Ten\" group (accept COVID-19 and non-COVID-19 patients), according to the epidemic prevention and control policy.

Results: Among 184 CRE-BSI cases confirmed during pre-COVID-19, COVID-19 until \"New Ten\" and post-\"New Ten\" periods, the CRE-BSI rates were 7.81, 8.13, and 9.63 cases per 100,000 hospitalization days. Correspondingly, the carbapenem resistance rates in Enterobacteriaceae were 18.6%,16.4%, and 19.0%, respectively, although no significant statistical differences were noted between the examined periods. The intensity of antimicrobial use increased significantly (p < 0.001) after the outbreak of the epidemic, and even increased to 1.5 times after the implementation of the \"New Ten\" compared to the pre-COVID-19 period. Notably, the utilization of third- and fourth-generation cephalosporins experienced a significant increase in CRE-BSI patients during the COVID-19 epidemic (p = 0.013).

Conclusions: During the epidemic, an increased broad-spectrum antimicrobial use happened in CRE-BSI patients.

Author Biographies

Changcheng Shi, Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China

Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province,

Shelan Liu, Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China

Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China

Shuying Wang, Department of Hospital Infection Management, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China

Department of Hospital Infection Management

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Published

2026-09-30

How to Cite

1.
Xu L, Shi C, Liu S, Wang S (2026) Impact of COVID-19 Pandemic on carbapenem-resistant Enterobacteriaceae bloodstream infection: a single-center study in China. J Infect Dev Ctries 20:1290–1297. doi: 10.3855/jidc.21495

Issue

Vol. 20 No. 09: September 2026

Section

Coronavirus Pandemic

License

Copyright (c) 2026 Lian Xu, Changcheng Shi, Shelan Liu, Shuying Wang

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