Impact of the COVID-19 pandemic on healthcare-associated infections and multidrug-resistant microorganisms in Italy: A systematic review.

BACKGROUND

The diffused and prolonged SARS-CoV-2 transmission lead to high levels of hospitalization. During this period, the focus of sanitary structures was to contain COVID-19 mortality and this may have reduced the application of health associated infection (HAI) and multidrug resistant microorganism (MDRO) prevention programs.

METHODS

A search was performed in PubMed, Science Direct, and Google Scholar databases to identify clinical observational studies that reported the impact of COVID-19 pandemic on the prevalence or incidence on HAIs and/or MDROs from December 2019 to August 2024 in Italy. Studies were included if they reported a comparison with pre-pandemic period and had a full-text available. Eligible studies were assessed for risk of bias and quality with NHI Quality Assessment Tool by two researchers independently. Data were represented in tables and a narrative synthesis was made in the text.

RESULTS

Selected studies included 4 studies reporting data on HAI (1497 total patients) and 11 studies reporting data on MDRO (80388 total patients). The majority of the studies reported an increase in HAI prevalence (9-11.1 % range) and MDRO, in particular, gram negative MDRO had an increase range of 0.8 %-45.6 % and gram positive MDRO an increase range of 0.5 %-81.8 % from pre- to post-COVID-19 period in the different studies considered

CONCLUSION

These findings underscore the critical need for active surveillance in hospital wards, the implementation of antibiotic stewardship and prescribing programs to mitigate the impact of such crises on healthcare-associated infections and antimicrobial resistance. Furthermore, permanent training of healthcare personnel is necessary.