Have Contamination Rates Increased In Intensive Care Units During The COVID-19 Pandemic?

Objective: In this study, the COVID-19 pandemic; Due to reasons such as prolonged hospital stay in intensive care units (ICU), the use of various drugs in different regimens (such as high-dose steroids), increased workload, rapid patient circulation, there is no difference in the distribution of bacterial pathogens and contamination rates that may cause blood infections in ICUs compared to the pre-pandemic period. We aimed to examine whether it causes a change or not.

Materials and Methods: In our study; Between April 1, 2020, and March 31, 2022, when the COVID-19 ICUs of our hospital were actively serving, real-time reverse transcriptase polymerase chain reaction (RT-PCR) test was positive in oropharyngeal and nasopharyngeal swabs in these ICUs, or the PCR test was negative. In this study, microorganisms grown in blood cultures of patients with clinical diagnosis of COVID-19 and blood culture contamination rates were compared with the blood culture growth and contamination rates of patients hospitalized in various ICUs between March 1, 2018 and February 29, 2020, which we accept as the pre-pandemic period (PPP).

Results: In our study, 2475 blood cultures taken from 1092 patients followed in COVID-19 intensive care clinics were sent to our laboratory in pandemic period (PP). Of this patient group, 640 were men and 452 were women. The mean age was calculated as 70.23 (18-100). In PPP, a total of 5854 blood cultures from 1968 patients came to our laboratory from different intensive care clinics of our hospital. Of these patients, 1164 were male and 804 were female. The mean age was calculated as 63.16 (0-99). No growth was detected in 57.87%(3388) of the samples received in PPD, and the causative microorganism was isolated in 38.81%(2272). Contamination rate was 3.31% (194). In PP, growth was not detected in 48.81% (1208) of the incoming samples, while the causative microorganism was isolated in 28.89% (715), the contamination rate was calculated as 22.30% (552). The most common causative bacteria isolated in PP was Klebsiella pneumoniae (24.34%). Staphylococcus epidermidis (17.05%) was the most frequently isolated causative bacteria in PPP.

Conclusion: As a result, in our study, it was seen that the most commonly grown bacteria in blood cultures were CNS. CNSs are isolates that are generally considered contaminants. When PD and PPV are compared, there is a significant increase in contamination rates.