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已发表论文
2019 冠状病毒病大流行对感染性胰腺坏死中多重耐药菌感染的影响：一项事后队列分析
Authors Liu B, Ning C, Li J, Sun Z, Lin C, Hong X, Guo R , Chen L, Shen D , Huang G
Received 12 May 2025
Accepted for publication 11 September 2025
Published 18 September 2025 Volume 2025:18 Pages 4981—4991
DOI https://doi.org/10.2147/IDR.S535563
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Chi H. Lee
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 China
Correspondence: Gengwen Huang, Department of Pancreatic Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China, Email huanggengwen@csu.edu.cn
Background: 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
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 China
Correspondence: Gengwen Huang, Department of Pancreatic Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China, Email huanggengwen@csu.edu.cn
Background: 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