CO21 | The strategy on healthcare-associated infections prevention in patients with previous SARS-CoV 2 infection. Analysis of the cost and consumption of antibiotics

M. Lugarà¹, D. Birra², C. Bologna¹, D.V. Iula³, R. Piscitelli⁴, R. Natale⁵, L.M. Capece⁵, P. Tirelli¹, M. Borrelli⁵, V. Nuzzo¹ | ¹Presidio Ospedaliero Del Mare -Unit of General Internal Medicine, Naples, ²Presidio Ospedaliero Del Mare -Unit of General Internal Medicine Naples, ³Presidio Ospedaliero Del Mare, Microbiology Unit, Naples, ⁴Presidio Ospedaliero Del Mare, Department of Pharmacy, Naples, ⁵Department of clinical Medicine an d Surgery-Internal Medicine-University Federico II, Naples, Italy

Abstract

Purpose of the study: Healthcare-associated-infections represent frequent complications of hospital care. Active surveillance activities, prevalence and incidence investigations are fundamental, as a described in PNCAR 2022-2025.
Materials and Methods: the “Ospedale del Mare” showed a 30% increase in super-infections from MDR germs, particular Acinetobacter B. also in Sars-CoV-2 patients. Within 24 hours of hospitalization, patients underwent rectal swab for MDR germs and nasal swab for MRSA.
Results: Comparison between 2021 vs. 2022 showed in 2022 24% increase in positive MRSA nasal swabs in General Medicine (GM), 21% in ICU and 43% in Emergency Medicine (EM). In 2022 there was a 25% increase in positive MDR rectal swabs in GM, 30% in ICU and 41% in EM. Surveillance strategy highlighted an increased rate of MDR germs, particularly Acinetobacter without significant difference in 2022.
Conclusions: Early identification of colonized patients in GM led to 3.4% reduction of meropenem DDD (2021 vs. 2022) and -45% of costs, while for ceftazidime/avibactam -55.3% and -52.4%. In EM, 100% DDD reduction, while in ICU there was a +533% DDD increase, with increased cost by 579%. The cost analysis for all UUOOs for ceftazidime\avibactam showed 19% increase, also due to 14% price reduction. The sub-analysis of the ICU data showed that, despite the increased costs for antibiotic therapy and the number of MDR colonization/infections, the mortality rate lowers from 71.8% in 2021 to 63% in 2022 with an average stay in ICU of 17 days in 2021 rather than 16 days in 2022, showing a slight reduction.